< Billing codes

Billing code

A203A — Obstetrics and gynaecology specific assessment

OB/GYN specific assessment

An obstetrician-gynaecologist bills A203 for a full history of the complaint and detailed exam of the affected parts or systems.

Watch for: One per patient per physician per 12 months, two only for an unrelated diagnosis; extras pay as a lesser assessment.

Code

A203A

Description

Obstetrics and gynaecology specific 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

An OB/GYN's full assessment of the presenting complaint with a detailed exam of the affected parts or systems.

What it covers

A specific assessment is a specialist service, rendered somewhere other than the patient's home, that needs a full history of the presenting complaint and a detailed examination of the affected part(s), region(s) or system(s) needed to make a diagnosis, exclude disease and/or assess function (GP23).

A203 is the Obstetrics and Gynaecology (20) office and general listing. Includes, where indicated, biopsy of the cervix, collection of cervical cancer screening specimen(s) and examination of a trichomonas suspension (A151).

Billing rules

• Limited to 1 per patient per physician per 12 months, or 2 if the patient returns with a clearly different, unrelated diagnosis. Extra ones are paid as a lesser assessment (GP23).
• Add E432 when a pelvic exam with speculum is done outside a hospital or ICHSC. E432 is limited to one per patient per day, must be done personally, and is not payable with E430, E431 or E542 (A150).
• Cervical screening collection is included when the pelvic exam is a normal part of the visit, but E430 or E431 can be added when it is done outside a hospital or ICHSC (A150).
• Can be done by video or phone with an existing patient-physician relationship; add K300A or K301A. Phone pays 85% of the in-person fee (Appendix J AJ1, A70).

Often billed with

• E432 pelvic exam with speculum outside hospital or ICHSC (A150).
• E430 or E431 cervical cancer screening collection (A150).

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: A204, A205, A206, C203, E432, E430

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Obstetrics and Gynaecology (20), page A150. Rules GP23.

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