FHO+ Payment Model and PSA Resources
The new FHO+ model has sparked many questions, and we’re here to help. Explore our resources for a one-stop shop on all the information you need to keep up-to-date on the changes to physician compensation in Ontario.
Curious how FHO+ could impact your practice? We can help.
Book a free income analysis with our team to find out how the FHO+ model can affect your practice and earnings.
What is the FHO+ Model?
The FHO+ model is an enhancement to the existing Family Health Organization payment structure. Rather than a complete overhaul, it’s designed to address key gaps in physician compensation, with a focus on recognizing the full scope of patient care and enhancing revenue potential.
FHO+ Payment Structure
The FHO+ compensation structure is composed of 4 different payment categories:
- Time-based billing for direct and indirect care and admin work
- Increased shadow billing for regular and after-hours care
- Attachment bonus for newly rostered patients
- Capitation payment (base rate payment) per rostered patient
PSA Updates
With the changes to the existing FHO model, the Ministry is also applying compensation increases to physicians’ Remittance Advice.
March 31, 2026: End of prior (Year 2) relativity-adjusted payment rates
April 1, 2026: Year 3 PSA increases take effect for services provided April 1, 2026 – March 31, 2027
- New relativity-adjusted payment rates applied to fee-for-service and automated payments (capitation, premiums, salaries)
- Rates vary by model:
- FFS / FHG / CCM: ~6.29%
- FHO / FHN / GHC: ~4.85%
Overall PSA Context
- Year 3 reflects an overall compounded increase of 5.37%, applied differently across specialties and payment models
Watch our webinar "FHO+: Preparing Your Practice for What's Next", now available on demand!
Ontario’s proposed FHO+ model could reshape how family physicians are compensated – impacting clinic workflows, revenue streams, and patient care delivery. Watch our recent webinar to learn about the changes to the FHO model and how the upcoming FHO+ model may affect your practice.
FHO+ Model & PSA Resources
All the information you need, in one place.
Blog: FHO+ Hourly Billing Explained: A Complete Guide for Ontario Physicians
Blog: Understanding the Proposed FHO+ Model: What Ontario Family Physicians Need to Know
Also, by signing up for our newsletter, you can stay up to date on any OHIP billing and PSA changes.
FHO+ Model FAQs
Yes. The Access Bonus will be discontinued under the new FHO+ model. This bonus will be repurposed through the hourly time-based payments, as well as the increase in shadow billing.
- Hourly billing for direct services- Time spent directly with patients ($80/hour)
- Hourly billing for indirect services- Charting, reviewing lab results, billing, and other administrative tasks ($80/hour)
- Hourly billing for clinical administration- Roster management, chronic disease patient management, and other clinical oversight activities ($80/hour)
- Patient Attachment Bonuses- Depending on whether you are a new FHO physician or not, you will receive a bonus (from $100 to $270) per rostered patient based on their age and RIO.
Physicians should submit codes Q310 (Direct Care), Q311 (Direct Telephone Care), Q312 (Indirect Care) and Q313 (Clinical Administration) based on services/tasks performed.
With a time-based model, maintaining clear, consistent documentation will be essential to ensuring compliance and supporting your billed hours. You are required to maintain records of your total time spent in each category per day.
Physicians must maintain records of:
- Total hours per category
- Brief activity descriptions (for indirect/admin)
Example of documentation summaries:
“April 1 — Indirect Care — 1 hour — chart reviews”
“April 1 — Direct Care — 4 hours”
“April 1 — Direct Telephone Care — 1 hour”
Only the total daily duration needs to be recorded — you are not required to document specific start and stop times. Documentation also does not need to be maintained at the individual patient level.
- Shadow billing: Most in-basket codes will see increases to 30% of the full Fee-for-Service (FFS) rate. Select procedure codes will receive even higher increases to 50% of FFS rates.
- Q012 after-hours: The after-hours premium will increase from 30% to 50%, providing better compensation for physicians who provide extended care to their patients outside regular business hours.
- GMLP: The GMLP will be increased up to 4 times the current rate, providing better compensation for physicians who take on leadership roles within their FHO groups.
- Hospital-Based Services: In-basket services performed in a hospital setting will be considered out-of-basket and paid at full FFS rates, ensuring physicians receive appropriate compensation for hospital-based care.
We are offering a complimentary income analysis to demonstrate how transitioning to the proposed FHO+ model can enhance the patient experience and get you one step closer to new financial heights.
