Under the new FHO+ model, you can receive compensation for time spent on direct patient care, indirect patient care, and clinical administration for rostered patients. You can use the CHR to document your time for each of these activities and submit bills for the new hourly rate codes.
💡Tip: OntarioMD provides a FHO+ Hourly Rate Calculator to help keep track of your hours to stay within the daily and monthly billing limits. The FHO+ calculator is a supplementary tool and does not replace your time-based activity documentation in the CHR for audit purposes.
Steps
Ensure your patients' roster statuses are up to date in Patient Data > Enrollment. You can use the monthly Roster and Capitation Payment reports you receive from the MOH and update the roster status in the CHR accordingly.
Create a fake patient for each provider, to track your daily time-based activities. Include the provider's initials or name in the surname of the patient. For example, enter a surname of "FHO-Smith" and first name "Hourly Tracking".
📌Note: The health number must be 9777777779 in order for MDBilling to identify it as a fake patient and remove the patient details before sending the claim to the MOH. You must also add the fake patient in MDBilling.
Create an encounter template to use in the fake patient's chart to track your time-based activities. Refer to the sample encounter template at the end of this topic, for the example template from OntarioMD.
Each day, create an encounter in the fake patient’s chart using the template and record your applicable FHO+ hours and activities. This provides a consistent method of documenting time and activities for each category and ensures the information is available for audit purposes.
Create a bill for each day's time spent on these time-based activities. The hourly codes are billed in 15-minute increments. For example, if you spend one hour on indirect patient care activities, you would bill four units. Refer to Billing services to the Ministry of Health that are not linked to a patient for more information.
💡Tip: You can also use the appointment schedule to help with tracking:
Set up appointment tags to distinguish between rostered and non-rostered patients, to easily identify patients in the schedule for which you can track the time-based activities.
Set up appointment types to identify appointments for each of the time-based activities (Direct care - in-person or video, Direct telephone-based care - not in office, Indirect care, and Clinical administration time).
Schedule a recurring daily appointment for your fake patient, as a reminder to document your time-based activities for the day.
Sample encounter template
1. Direct Hours:
2. Direct Care Phone Out of Office Hours:
3. Indirect Hours:
4. Clinical Administration Time Hours:
Indirect Activities (pick all that apply)
- Paperwork (e.g. charting and documentation, preparing referrals and requisitions, completing clinical forms, reports and medical certificates of death, excluding third-party requests)
- Coordinating and planning care (e.g. chart reviews, reviewing results such as labs, imaging, consult notes)
- Conferencing, consulting and meeting with other physicians and healthcare professionals for a specific patient or patients
- Conferencing and meeting with family members and/or patient medical representatives
- Discussion with, and providing advice and information to the patient or the patient's representative that is an insured service directly related to pre- or post-direct patient care, via synchronous or asynchronous care communication
- Reviewing clinical information or research directly related to the needs of a particular patient
- Patient-specific clinical teaching arising from direct patient care
- Other
Clinical Administration Time (pick all that apply)
- Proactive patient management (e.g. screenings, chronic disease)
- EMR updates requiring physician expertise
- Quality improvement initiatives
- Other
📌Note: The methods for tracking time-based activities are suggestions only and should be adapted as needed to suit your specific workflow. The guidelines stipulate you must track the time; the method of tracking is at your discretion.
Updated April 24, 2026