Ontario’s Patient Attachment Bonus Codes Are Live: What Family Doctors Need to Know

Ontario’s new Patient Attachment Bonus codes are now billable. On November 2, 2026, the Ministry of Health issued INFOBulletin 261102, which confirms the fee codes, the amounts and the rules. Claims can go back to July 1, 2025.

For a lot of practices, that means real money for patients they’ve already rostered. It also means a handful of rules that can quietly turn a claim into $0. Here’s what you need to know.

Who can bill the Patient Attachment Bonus

The bonus applies to eligible physicians in every patient enrolment model (PEM), including FHO, FHN, FHG, CCM, BSM, GHC, RNPGA and the Rural Generalist Model. It’s a one-time payment for enrolling an eligible unattached patient.

Locum physicians and nurse practitioners can’t bill it. Physicians on Income Stabilization can, but they have to submit the codes under their group number.

The rates: Q027A and Q037A

There are two codes. Which one you bill depends on whether you’re an established doctor or a new graduate.

Q027A, established doctors:

• $100 for patients aged 0-64, or $120 for 65+, when your RIO score is under 40
• $150 or $180 when your RIO score is 40 or higher

Q037A, new graduates:

• $150 for patients aged 0-64, or $180 for 65+, when your RIO score is under 40
• $225 or $270 when your RIO score is 40 or higher

You bill both codes at the lowest fee value, and the ministry adjusts the payment for the patient’s age and the RIO score. For Q027A, the bulletin says that’s the RIO score of the physician or their group, whichever is higher. The OMA has a RIO postal code look-up if you’re not sure of yours.

New graduate means you joined a PEM within three years of finishing family medicine residency, or you’re an international medical graduate who has completed family medicine postgraduate training and holds an independent practice licence. New-grad status lasts up to 12 months after you join the PEM. Bill the wrong code for your status and the claim gets rejected.

Q027A and Q037A expire on March 31, 2028.

Other new patient fees

The bulletin also brings in three new patient fees:

• Q051A, Mother/Newborn New Patient Fee: $350 for enrolling an unattached mother and newborn within two weeks of birth, or an unattached pregnant patient after 30 weeks.
• Q052A, Multiple/Newborn New Patient Fee: $150 for each additional newborn in a multiple birth. Each newborn has to be enrolled within 90 days of birth.
• Q058A, HCC Complex/Vulnerable Unattached New Patient Fee: $500 for a Health Care Connect patient who is identified as complex/vulnerable, either by HCC or by you based on your clinical judgment. If you make that call yourself, document it in the chart.

Q058A replaces Q053A from November 1, 2026. Q053A has been raised to $500 retroactive to July 1, 2025, and the ministry will adjust claims it has already paid, so you don’t need to do anything. The existing Q023A (unattached patient from hospital) and Q043A (FIT positive/colorectal cancer increased risk) codes continue.

Only one attachment bonus or new patient fee is paid per patient, per group.

How to avoid a $0 claim

This is where most of the money gets lost. Before you submit, check these five things.

1. A same-day in-person visit. Q027A and Q037A need an insured service billed on the same service date as the bonus. The visit has to be in person in your usual family practice setting, not virtual. It can be fee-for-service or shadow billed, and it doesn’t have to be the first visit. Without a matching visit, the claim pays $0. For past enrolments, back-date the bonus to the date of an in-person visit on or after enrolment.
2. Both forms. The patient needs to complete the Primary Health Care New Patient Declaration form and the Patient Enrolment and Consent to Release Personal Health Information form. Keep copies in the chart.
3. A patient who is new to you and your group. If the patient was ever enrolled to you or anyone in your group, even years ago and even if nobody claimed a bonus, the claim pays $0. Roster transfers within a group don’t create a new bonus.
4. Enrolment with Q200A on or after July 1, 2025. Patients enrolled before that date pay $0.
5. Keep them rostered for 12 months. If you or your group de-enrol the patient within 12 months, the bonus is recovered.

Key dates for retroactive claims

• Claims could be submitted starting November 1, 2026.
• For patients enrolled from July 1, 2025 to October 31, 2026, retro claims must be submitted before the May 2027 OHIP claims processing cut-off. Stale-date rules don’t apply until then.
• If you don’t have a New Patient Declaration form for one of those patients, you have 12 months from November 1, 2026 to get it.
• Enrolments from November 1, 2026 onward follow the normal three-month claim submission window.

For most practices, the work is the look-back. That means pulling every patient rostered since July 1, 2025, confirming they’re truly new to the group, matching each one to an in-person visit date, and chasing missing declaration forms.

Is your billing agent keeping up?

Changes like this are exactly where claims fall through the cracks. If your OHIP billing agent isn’t on top of billing updates, or claims keep getting missed or rejected, it can cost you without you ever seeing it.

We can help. MedPros will review who you’ve rostered since July 2025, flag what qualifies, and get your retro claims in before the May 2027 cut-off. Call us at 416-479-0077 or email info@medpros.ca.

Source: Ontario Ministry of Health, INFOBulletin 261102: New patient and attachment bonus fee schedule codes (November 2, 2026). This article is a summary for general information, not billing advice for your specific practice.

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