< Billing codes

Billing code

A138A — Internal medicine partial assessment

Brief internal medicine visit

An internist bills A138 for a partial assessment: history of the presenting complaint, needed exam, advice and a record.

Watch for: Billed as virtual care only with an existing patient relationship and K300A or K301A; telephone pays 85% of the fee.

Code

A138A

Description

Internal 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

Brief assessment by an internist: history of the presenting complaint, needed exam, advice and a record.

What it covers

A138 is the Internal Medicine (13) partial assessment (A129). 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).

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).
• Only one assessment is paid per visit, even if you hold more than one specialty (GP10).
• 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, A131, A135, A120

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A129. Assessment rules GP23–GP25.

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