Billing code
A131A — Internal medicine complex medical specific re-assessment
Complex internal medicine re-assessment
An internist bills A131 to re-assess a complex, obscure or serious condition, with a written report to the family doctor.
Watch for: Send your findings in writing to the primary care physician, or OHIP pays a lesser fee; limit 4 per patient per 12 months.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $83.40 | $0.00 | $0.00 | $0.00 |
- Code
- A131A
- Description
- Internal medicine complex medical specific re-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
Re-assessment by an internist for a complex, obscure or serious condition, with a written report to the family doctor.
What it covers
A131 is the Internal Medicine (13) complex medical specific re-assessment (A129). A complex medical specific re-assessment is a re-assessment needed because the patient's condition is complex, obscure or serious. It includes everything in a medical specific re-assessment (GP24).
Billing rules
- Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Internal Medicine (13) (GP9).
- Send your findings, opinion or recommendations in writing to the patient's primary care physician, or OHIP pays a lesser assessment fee (GP24).
- Limited to 4 per patient per physician per 12 months, and counts toward the combined limit of 4 with medical specific assessments. Extras pay a lesser fee (GP24).
- 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: A133, A134, A138, C131, A136
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A129. Assessment rules GP23–GP25.
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