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Billing code

A118A — Critical care medicine partial assessment

Brief critical care visit

A critical care medicine specialist bills A118 for a partial assessment: history of the complaint, needed exam, advice and a record.

Watch for: Billed as virtual care only with an existing patient relationship and K300A or K301A; in-patient visits use the C-prefix codes instead.

Code

A118A

Description

Critical care medicine partial 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

Partial assessment by a critical care medicine specialist: history of the presenting complaint, needed exam, advice and a record.

What it covers

A118 is the partial assessment in the Critical Care Medicine (11) General Listings (A89). A partial assessment is a limited service: a history of the presenting complaint, the necessary physical examination, advice to the patient and an appropriate record (GP25).

In-patient critical care visits use the C-prefix listings instead, such as subsequent visits C112, C117 and C119 (A89).

Billing rules

• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Critical Care Medicine (11) (GP9).
• Only one assessment is paid per visit, even if you hold more than one specialty (GP10).
• Physicians in hospital but not on duty in the ED use the General Listings when seeing patients in the ED or out-patient department (A89).
• Can be done by video or phone when you have an existing relationship with the patient (for example, an in-person visit with you in the past 24 months). Add K300A (video) or K301A (phone); phone pays 85% of the fee (AJ1, A66, A70).

Common rejections

• AT3: Billed as virtual care (K300A/K301A) but OHIP found no existing patient-physician relationship, such as an in-person service with you in the past 24 months (A66).

Related codes: A713, A114, A111, A715, A710, A915, A116, C112

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Critical Care Medicine (11), page A89. Partial assessment definition GP25.

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