What are the billing rules for A101A?

Bill limited virtual care only when there is no existing patient-physician relationship. With a relationship, bill the in-person code with K300A or K301A instead (A66, A70). The service must include at least a history and a medically appropriate exam, a diagnosis, and a management plan or management (A73). Not payable if the service can't be done properly without an in-person exam; then only the in-person service is paid (A67).

Why is A101A rejected?

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. R04: OHIP's description is 'service excluded from RMBS', the reciprocal billing system for patients insured by another province. The service can't be billed through reciprocal billing for that patient. A3H: The claim billed more services of the code than OHIP allows. Reduce the number of services to the allowed limit and resubmit.

< Billing codes

Billing code

A101A — Limited Virtual Care by Video

Q: What is OHIP billing code A101A?

Limited virtual care by video, for a patient with no existing relationship with the physician (no in-person visit in 24 months, not enrolled).

Limited virtual care by video

Bill A101 for a video assessment of a patient with no existing relationship: no in-person visit with you in 24 months and not enrolled.

Watch for: If you do have an existing relationship, bill the in-person code with K300A or K301A instead of A101.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$20.00	$0.00	$0.00	$0.00	$0.00

Code: A101A
Description: Limited Virtual Care by Video
FHO+ basket: Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).
Effective date: Jun 1, 2025
Termination date: No end date

Explanation

Updated October 26, 2026

Limited virtual care by video, for a patient with no existing relationship with the physician (no in-person visit in 24 months, not enrolled).

What it covers

A101 is limited virtual care by video: an assessment by two-way synchronous video on a platform verified by Ontario Health, for a patient who has no existing patient-physician relationship with the physician (A67, A73).

An existing relationship includes an in-person insured service by that physician in the past 24 months, or enrolment to that physician or their group. Without one, comprehensive virtual codes can't be billed, and limited virtual care is the option (A66, A70).

Billing rules

Bill limited virtual care only when there is no existing patient-physician relationship. With a relationship, bill the in-person code with K300A or K301A instead (A66, A70).
The service must include at least a history and a medically appropriate exam, a diagnosis, and a management plan or management (A73).
Not payable if the service can't be done properly without an in-person exam; then only the in-person service is paid (A67).
The visit must be initiated by the patient or their representative, or be a medically necessary follow-up. Check-in and administrative calls are not payable (A68).
The chart must record the modality used (A68).
The patient and physician must both be in Ontario, and the physician must render the service personally (A69).
The virtual care premiums on page A74 apply only to comprehensive virtual care, not to limited virtual care (A74).
Video must use a platform on Ontario Health's list of verified virtual visit solutions (A68).

Common rejections

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.
R04: OHIP's description is 'service excluded from RMBS', the reciprocal billing system for patients insured by another province. The service can't be billed through reciprocal billing for that patient.
A3H: The claim billed more services of the code than OHIP allows. Reduce the number of services to the allowed limit and resubmit.

Related codes: A102, K300, K301, A007, A001

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Virtual Care Services, pages A66 to A73; Appendix J Section 2 (AJ3)

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing