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Billing code

A001A — Minor Assessment

Brief family practice visit

Bill A001 for a brief history and exam of the affected part, or brief advice about a health issue.

Watch for: If the problem needs a more extensive exam of the affected parts or systems, bill an intermediate assessment (A007) instead.

Code

A001A

Description

Minor Assessment

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Family practice minor assessment: a brief history and exam of the affected part, or brief advice or information about a health issue.

What it covers

A001 is the Family Practice minor assessment. It includes one or both of: a brief history and examination of the affected part or region, or related to a mental or emotional disorder; or brief advice or information about health maintenance, diagnosis, treatment or prognosis (GP27).

When the problem needs a more extensive examination of the affected parts or systems, the visit is an intermediate assessment (A007) instead (GP27).

Billing rules

• In the patient's home, travel to and from the home is part of A001, and the Table VI home special visit premiums are not payable with it (A4).
• A008 mini assessment is only payable when the WSIB part of the same visit was billed as A001 and an unrelated non-WSIB problem was also assessed (A4).
• Detention (K001) can only start after 30 minutes of a minor assessment (GP30).
• Can be billed by video or telephone as comprehensive virtual care when an existing patient-physician relationship exists, with K300A or K301A (A70, AJ1).
• On the day of a Z-code procedure, if the same physician did the major pre-operative visit in the previous 12 months, a minor assessment is the only assessment a family physician can bill before the procedure (SP4).

Often billed with

• E432 for a pelvic exam with speculum outside a hospital or ICHSC; once per day, not with E430, E431 or E542 (A4).
• E080 for the primary care physician's first office or home visit within two weeks of an acute care discharge (GP28).
• E079 smoking cessation initial discussion, once per patient per 12 months (A56).
• FHO: Q012A after-hours premium for enrolled patients (Agreement p.68; OMA Q-codes p.8).

Common rejections

• AT3: Billed by video or phone (K300A/K301A), but OHIP found no existing relationship: no in-person service in 24 months and no enrolment to you or your group (A66). Otherwise bill A101/A102.
• EH2: The health card version code doesn't match the Ministry's record. Get the current version code and resubmit.
• VH8: The date of birth doesn't match OHIP's record for the health number. Correct it and resubmit.
• EQE: The physician wasn't registered in the group on the claim on the service date. A registration issue, not a coding one.
• VJ7: OHIP received the claim more than three months after the service date (GP9). If it was first sent on time, use the stale-dated process.

Related codes: A007, A008, A003, A004, A102

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A4; General Preamble GP27 (minor assessment)

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