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Billing code

A471A — Respiratory complex medical specific re-assessment

Complex respirology re-assessment

Bill A471 when a respirologist re-assesses a patient because the condition is complex, obscure or serious.

Watch for: Send your findings in writing to the primary care physician, or it pays as a lesser assessment; limit 4 per 12 months.

Code

A471A

Description

Respiratory 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

Complex re-assessment by a respirologist for a complex, obscure or serious condition, with a written report to the primary care physician.

What it covers

A471 is a complex medical specific re-assessment by a specialist in Respiratory Disease (A197).

Re-assessment because of the complexity, obscurity or seriousness of the condition, with all the elements of a medical specific re-assessment. You must send your findings, opinion or recommendations in writing to the patient's primary care physician, or it pays as a lesser assessment (GP24).

Billing rules

• Limited to 4 per patient per physician per 12 months; excess claims pay as a lesser assessment (GP24).
• Medical specific assessments and complex medical specific re-assessments together are limited to 4 per patient per physician per 12 months (GP23, GP24).
• Add E078 (+50%) chronic disease assessment premium in the office or a hospital out-patient clinic (not ED, in-patient or LTC) when the patient has an established chronic disease from the GP26 diagnostic code list, such as 491–493 (A197, GP25–GP26).
• Can be done by video or phone with an existing patient relationship; add K300A (video) or K301A (phone) (AJ1, A66).

Often billed with

• E078 chronic disease assessment premium (+50%), office or hospital out-patient clinic only (A197, GP25).

Related codes: A474, A473, A570, A478, C471, E078

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A197. Rules GP24, GP25.

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