< Billing codes

Billing code

A113A — Complex Neurological Assessment

Complex neurology follow-up

A neurologist bills A113 for at least 20 minutes of ongoing care of a listed complex chronic neurological condition.

Watch for: Not for your first evaluation of the patient; limited to 6 per patient per physician per 12 months.

Code

A113A

Description

Complex Neurological Assessment

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

A neurologist's follow-up visit of at least 20 minutes for ongoing care of a listed complex chronic neurological condition.

What it covers

A complex neurological assessment is an assessment for ongoing management of a listed complex chronic neurological condition that needs continuing care by a neurologist, with at least 20 minutes in direct contact with the patient (A141).

It is for ongoing management of: generalized peripheral neuropathies, myopathies, neuromuscular junction and motor neurone diseases; malignant brain neoplasms, functional neurological disorder, chronic migraine or trigeminal autonomic cephalalgias, Huntington's chorea, trigeminal neuralgia, intracranial haemorrhage and stroke; and neuro-oncology conditions (primary CNS tumour, CNS metastasis, neurological complications of cancer therapy, paraneoplastic syndromes) (A141–A142).

Billing rules

• Must include the elements of a medical specific re-assessment, or it is paid as a lesser assessment (A142).
• Not payable for your initial evaluation of the patient; bill a consultation or assessment for that first visit (A142).
• Limited to 6 per patient per physician per 12 months; extra ones are paid as a lesser assessment (A142).
• The patient must have an established diagnosis of a chronic complex neurological disease documented in the chart (A142).
• Needs at least 20 minutes in direct contact with the patient, not counting other separately billable services. Record start and stop times, or it is paid at a lesser fee (A141, A142).
• E078 is not payable with A113 (A142).
• Not meant for uncomplicated conditions such as carpal tunnel syndrome, Bell's palsy or asymptomatic diabetic neuropathy (A142).
• Can be done by video or phone when you have an existing patient-physician relationship; add K300A (video) or K301A (phone). Phone pays 85% of the in-person fee (Appendix J AJ1, A70).

Common rejections

• AT3: Usually means it was billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person visit with you in the past 24 months (A66).

Related codes: C113, A184, A181, A183, A185, W113

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A142.

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