Every September, the Ministry of Health sends family physicians in patient enrolment models a projected Preventive Care Target Population/Service Report (TPSR). Most practices download it, glance at it, and file it. That is a missed opportunity. Used properly, it is a to-do list of patients who still need a bonus-eligible service before the fiscal year closes, and it lands just before flu season, which is where the most time-sensitive bonus sits. INFOBulletin 260805, issued August 25, is the ministry’s reminder that this year’s report is on its way.
What the Report Is, and Where to Find It
The TPSR is issued twice a year, in April and September. The April report closes out the previous fiscal year. The September report is a projection: it shows where each physician stands so far this year, so there is still time to act.
It arrives electronically through Medical Claims Electronic Data Transfer (MCEDT), in each physician’s Solo account. That detail matters. If a physician’s solo billing number is not registered for MCEDT, the report does not arrive. The ministry only sends paper reports to providers who still receive paper remittance advice.
For each physician, the report shows:
- Their target population: enrolled patients who meet the age and sex criteria for each of the five preventive care categories
- Eligible services already provided to consenting enrolled patients, according to ministry records
- Consenting enrolled patients for whom any physician in the group has submitted a tracking code
- Enrolled patients for whom the enrolling physician has submitted an exclusion code
Which Bonuses Your Model Can Still Claim
This is the part that trips practices up, because the answer depends on your payment model.
FHO and FHN physicians can no longer claim the pap smear, mammography or colorectal cancer screening bonuses. That change applies from fiscal year 2024 onward (billable from April 2025), as agreed between the ministry and the OMA. FHO and FHN physicians remain eligible for the influenza and childhood immunization bonuses. Physicians with fewer than 1,000 enrolled patients have those two bonuses prorated; physicians with 1,000 or more are not prorated.
FHG and CCM physicians remain eligible for all five categories, but only if they meet the minimum roster size on March 31 of the bonus year: 650 enrolled patients, or 450 for new graduates in their first year of practice. FHG and CCM physicians receive the projected TPSR in April and September regardless of their current roster size, so the report arriving is not a sign that you qualify. Check your monthly Roster and Capitation Payment and Reconciliation Report for your enrolled count.
If your practice mixes models, or has physicians who recently moved from FHG to FHO, make sure each physician knows which categories still apply to them. Chasing mammography completion for an FHO roster is effort that no longer earns a bonus, even if it still matters clinically.
The Five Categories at a Glance
| Category | Target population (as of the dates set by the ministry) | Tracking code | Exclusion code |
|---|---|---|---|
| Influenza vaccine | Enrolled patients 65 or older as of December 31 | Q130A | Not applicable |
| Cervical cancer screening | Enrolled patients with a cervix aged 25 to 69 | Q011A | Q140A |
| Mammography | Enrolled female, trans and non-binary patients aged 50 to 74 | Q131A | Q141A |
| Childhood immunizations | Enrolled patients aged 30 to 42 months | Q132A | Not applicable |
| Colorectal cancer screening | Enrolled patients aged 45 to 74 | Q133A | Q142A |
The influenza category deserves attention right now. Because the flu vaccine is not available until late fall, the September report only lists the target population for influenza, not services. The service period for the flu bonus runs through January 31. That gives your office roughly four months to reach enrolled patients aged 65 and over.
Tracking and Exclusion Codes: The Easiest Wins
Your percentage in each category is calculated against the target population. Two kinds of zero-dollar codes improve that percentage without a single extra procedure:
- Tracking codes record that a patient received the service somewhere else. If a patient tells you they got their flu shot at a workplace clinic or pharmacy, submit Q130A. The claim is billed at $0 and comes back on your remittance advice paid at $0 with explanatory code 30. That is expected.
- Exclusion codes remove patients who should not be in the target population. The bulletin lists the criteria, including a hysterectomy for cervical screening, a mastectomy or treatment for clinical breast disease for mammography, and known cancer being followed by a physician, inflammatory bowel disease, or a colonoscopy within the last 10 years for colorectal screening.
Both are submitted through normal billing practices. A patient chart note saying “flu shot at pharmacy” does nothing for your bonus until the tracking code is billed.
What You Should Do
- Confirm every physician’s solo billing number is registered for MCEDT. No registration, no report.
- Download the September TPSR for each physician and compare it against your EMR, category by category.
- Build a recall list of patients in the target population who have not yet received the service, starting with enrolled patients 65 and over for this flu season.
- Submit tracking codes for services patients received elsewhere, and exclusion codes for patients who meet the criteria.
- FHG and CCM practices: check roster size now. Eligibility is based on March 31. Make sure new patients are rostered promptly with the per patient rostering fee code so they count.
- Check your EMR. Bonus claims must be submitted without a health number, date of birth or version code. If you changed EMR vendors, confirm the new system allows this.
- Diarize April. Cumulative Preventive Care Bonus claims are submitted in April, and they are subject to regular three-month stale-dating rules. For the 2025-26 year, the ministry set the claims processing cut-off in June 2026, and only claims received by that date were guaranteed to be processed.
How MAP Can Help
The preventive care bonus rewards practices that track their rosters year-round, not just the week before claims are due. MAP’s OHIP Billing team reconciles TPSR reports against EMR data, flags missing tracking and exclusion codes, and makes sure cumulative bonus claims go out on time. Learn more at maphcm.com.