Limits and claims
Daily and monthly caps
Check the shared daily maximum and the prorated monthly maximum before submitting a large day or month.
Quick answer: All four hourly codes share a 56-unit, 14-hour daily maximum. The monthly maximum is 240 hours for 28 days and is prorated for longer months using the published unit limits.
Last reviewed September 9, 2026
Daily maximum
- Add Q310A, Q311A, Q312A, and Q313A together for the service date.
- The combined maximum is 56 units, or 14 hours.
- A single claim item above 56 units rejects with A3H.
- An incoming claim that exceeds the combined daily limit may be approved at $0 with explanatory code MD.
Published monthly limits
| Month length | Units | Published hour equivalent |
|---|---|---|
| 28 days | 960 | 240 hours |
| 29 days | 995 | 248.6 hours |
| 30 days | 1,029 | 257.1 hours |
| 31 days | 1,063 | 265.7 hours |
How Year 1 claims are handled
For service dates from April 1, 2026 through March 31, 2027, OMA guidance says the Ministry billing system applies the daily and prorated monthly maximums. A submission that takes the physician over a limit may be rejected. Review the available room before submitting a large claim and resubmit within the limit when necessary.
The 25% support-pool and 5% clinical-administration ratios are reconciled separately in Year 1. See Monthly ratio limits for that process.
Important notes
- These caps apply across all four hourly codes, not separately to each category.