OscarPro v2 Local

Ontario Holiday Billing Guide 2025: Key OHIP Billing Tips for OSCAR Pro Users  

As the holiday season approaches, many clinics experience a unique combination of reduced staffing, fluctuating schedules, and increased patient demand. This often creates added billing complexity – especially around OHIP billing codes for holidays and after-hours. To help you prepare, we’ve tailored this Holiday Billing Guide specifically for OSCAR Pro users, with tips on how to streamline billing and avoid common claim errors directly within your EMR. 

This guide covers the 2025 holiday billing schedule, key codes like A888, Q888 and Q012, and practical ways to use OSCAR Pro features to stay accurate and compliant. 

2025 Holiday OHIP Billing Schedule  

The Ministry of Health has announced special billing rules for emergency and after-hours services over the winter holiday period. 

Eligible Emergency Department Equivalent (A888/Q888) Dates 

  • December 25-31, 2025 
  • January 1, 2026 

 
Since no holidays fall on weekends in 2025, no additional eligible days have been added.  

Special Premium (Q012) Dates 

Q012 is limited to (all day): 

  • December 25 
  • December 26  
  • January 1 

Note: Q012 still applies during regular after-hours periods year-round. 

Q888: Weekend Access Code  

Q888 applies to unscheduled, in-person visits for enrolled FHO patients during weekends and holidays. 

Requirements: 

  • Patient must be enrolled in your FHO group 
  • Visit must be in-person 
  • Physician must provide three scheduled visit slots for each three-hour block  
  • Must submit with a valid diagnostic code 

OSCAR Pro Tip:  

Use the Roster Status field in the Demographic Record to verify that the patient is enrolled before billing Q888, which helps prevent the “I6-Premium Not Applicable” error. It’s also recommended to confirm that a Q200A has been processed in the billing history as an additional safeguard.

After-Hours Requirement for FHOs 

FHO groups must meet weekday after-hours obligations before billing Q888 on weekends. Once fulfilled, physicians have more flexibility to bill Q888 for unscheduled visits. 

How OSCAR Pro helps: 

  • Use Provider Schedules to organize after-hours blocks 
  • Track obligations using custom schedule labels, making it easier for billing staff to confirm Q888 eligibility. 

A888: Emergency Department Equivalent Code   

A888 is used for urgent, unscheduled assessments conducted outside a hospital emergency department. 

Key rules: 

  • No scheduled patients during the same block 
  • Applies to both enrolled and non-enrolled patients 
  • Visit must meet urgent/emergency criteria 

Common Issue: 

Physicians sometimes bill A888 during required FHO after-hours blocks – this is not permitted unless after-hours obligations have already been met. 

OSCAR Pro Tip: 

Check your Day sheets for pre-booked appointments before applying A888. If any scheduled patients appear, the visit is not eligible. 

A888 vs. Q888 – Quick Reference 

Code Purpose When Used Notes 
A888 Emergency department equivalent Unscheduled urgent visits No scheduled patients allowed 
Q888 Weekend access Scheduled + unscheduled enrolled patients Only to enrolled patients, must meet FHO after-hours rules  

Q012 Premium Code 

Q012 adds a 30% premium to eligible enrolled patient visits completed during approved after-hours coverage. 

Key Reminders: 

  • Applies once per patient per visit 
  • Must be submitted with the qualifying fee code – A001, A003, A004, A007, A008, A888, K005, K013, K017, K030, K033, K130, K131, K132, Q050, Q888. If you bill anything else with the Q012 code, you will get an IA error 
  • Submitting Q012 separately will trigger an AD9 error 
  • Submitted more than one Q012 per claim triggers an A3H error 

OSCAR Pro Tip  

Create supercodes that automatically pair Q012 with all eligible codes to reduce missed premiums and minimize error messages. Note: If you create the supercode within “Create an Invoice Error,” it will be saved permanently and available for future use. You can label supercodes for easy reference—for example: After Hours, Weekend Walk-In FHO, Weekend Walk-In Non-FHO, Phone Calls, and so on. 

Common Holiday Billing Errors – and How OSCAR Pro Helps Prevent Them  

1. Q012 billed without a qualifying fee code 

  • Create supercodes with all eligible codes and Q012A to reduce billing errors.

2. A888 billed even though scheduled patients exist 

  • Quickly verify the schedule and ensure there are no prebooked appointments through the Day Sheet before submitting. 

3. I6 errors due to unenrolled patients 

  • Always confirm roster status in the patient’s Master Demographic Record. 

4. Incorrect weekend/holiday date billing 

  • Use OSCAR Pro’s Calendar Indicators to confirm statutory holiday billing periods before claims go out. 

Keeping Your Roster Updated 

Many billing errors occur when patient enrollment is outdated. Periodically review: 

  • Roster status in each Demographic Record 
  • Q200 submissions 
  • MCEDT enrolment files/RCP 

Staying on top of roster maintenance ensures more accurate submissions—especially for Q888 and Q012. 

The holiday season brings unique billing challenges, but OSCAR Pro gives you the tools to stay organized, compliant, and confident. By using built-in features like roster status checks, scheduling tools, billing templates, and Day Sheet views, you can simplify OHIP billing and reduce errors during this busy period. 

About OSCAR PRO

Oscar Pro is a comprehensive platform designed to streamline various aspects of medical practice management. Our EMR offers a range of features tailored to meet the needs of healthcare providers, from electronic medical records to appointment scheduling and billing.

Have questions or looking to get started? Contact us today info@oscarprodesk.ca.