$$\left[ \begin{matrix} a & b \\ c & d \end{matrix}\right] \left[ \begin{matrix} q_0 \\ 1 \end{matrix}\right]=\left[ \begin{matrix} aq_0+b \\ cq_0+d \end{matrix}\right]$$
Suppose we wanted $q=q_0/2$. Then we would need to find $aq_0+b=q_0/2$. But then $b=q_0(a-1/2)$. $b$ is an integer, so that means that $q_0$ must have in its irreducible decomposition a factor of two in the numerator, i.e. $q_0=\frac{2n}{m}$ where $m$ is odd. Then $b=\frac{n}{m}(2a-1)$; $b$ is still an integer, so it must be that $m=\pm 1$, and thus $q_0$ was an integer all along. (note that the fact that the determinant was one didn't even matter to see this)
Assuming I understood your question well, you're asking that given a fixed $q_0$, can we get the rest of the rationals using elements of $SL_2(\mathbb{Z})$, then choosing any non-integral rational number $q$ at this point shows that in general, the answer is no.