Billing code
A484A — Rheumatology medical specific re-assessment
Rheumatology follow-up assessment
Bill A484 for a rheumatologist's follow-up with a full relevant history and exam of one or more systems.
Watch for: Limited to two per patient per physician per 12 months, except hospital admission re-assessments; extras pay a lesser fee.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $72.00 | $0.00 | $0.00 | $0.00 |
- Code
- A484A
- Description
- Rheumatology 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
Medical specific re-assessment by a rheumatologist: full relevant history and exam of one or more systems. Two per patient per 12 months.
What it covers
A medical specific re-assessment is rendered by a specialist and requires a full, relevant history and physical exam of one or more systems (GP23).
For rheumatology services not listed in the Rheumatology section, use the Internal Medicine listings (A200).
Billing rules
- Limited to two per patient per physician per 12 months (except hospital admission re-assessments); extras are paid at a lesser fee (GP23).
- Add E078 (+50%) 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 listed diagnostic codes, documented in the chart (A200, GP25–GP26).
- Detention (K001) may start after 40 minutes (GP30).
- Can be done by video or telephone with an existing relationship; add K300A or K301A (Appendix J, A66).
Often billed with
- E078 chronic disease assessment premium (A200, GP25).
Common rejections
- AT3: Billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person service with you in the past 24 months (A66).
Related codes: A483, A481, A480, A488, E078, C484
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), page A200.
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