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Billing code

A488A — Rheumatology partial assessment

Rheumatology partial assessment

Bill A488 for a limited rheumatology visit: history of the complaint, the needed exam, advice and a record.

Watch for: Add E078 in the office or out-patient clinic for an established chronic disease from the listed diagnostic codes, documented in the chart.

Code

A488A

Description

Rheumatology 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

Partial assessment by a rheumatologist: history of the complaint, the needed exam, advice and a record.

What it covers

A partial assessment is a limited service made up of a history of the presenting complaint, the necessary physical exam, advice to the patient and an appropriate record (GP25).

For rheumatology services not listed in the Rheumatology section, use the Internal Medicine listings (A200).

Billing rules

• 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).
• On the day of a Z-code procedure, if you did the major pre-operative visit in the prior 12 months, a partial assessment is the only assessment payable before the procedure (SP4).
• Detention (K001) may start after 30 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: A484, A483, A481, E078, A485

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), page A200.

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