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Billing code

A004A — General Reassessment

Repeat full checkup

Bill A004 when you already did a general assessment and the patient needs another full exam of all systems, with a shortened history.

Watch for: Limited to two per patient per physician per 12 months, except for hospital admissions; extras are paid at a lesser fee.

Code

A004A

Description

General Reassessment

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 general re-assessment: a full assessment of all systems where the history can be shortened. Two per patient per 12 months.

What it covers

A004 includes everything listed for a general assessment (full examination of all body parts and systems), except that the history doesn't need to repeat the details already gathered in the original assessment (GP22).

It is used when the physician has already done a general assessment and the patient needs another full assessment (GP22).

Billing rules

• Limited to two per patient per physician per 12 months, except general re-assessments for hospital admissions. Extra ones are paid at a lesser assessment fee (GP22).
• Patients aged 65 or older: paid with a 15% age premium (GP64).
• A004 is not on the Appendix J list, so it can't be billed by video or telephone (A68, AJ1, AJ2).
• Collecting a cervical screening specimen is included when the pelvic exam is a normal part of the re-assessment; E430 or E431 may be added outside a hospital or ICHSC (A4).
• Detention (K001) can only start after 40 minutes of a general re-assessment (GP30).
• When the admitting physician saw the patient for the same illness within the 90 days before admission, the admission assessment is a general re-assessment (GP40).

Often billed with

• E430 or E431 for cervical screening outside a hospital or ICHSC (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

• EH2: The health card version code doesn't match the Ministry's record. Get the current version code and resubmit.
• V22: The diagnostic code isn't a valid OHIP code. Replace it with the three-digit code for the main reason for the visit.

Related codes: A003, A007, A001, C004

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A4; General Preamble GP22 (general re-assessment)

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