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Billing code

E430A — Pap Smear Tray Fee (G365)

Office Pap test premium

Add to G365, or to the visit that included the pelvic exam, when a cervical screening specimen is collected outside hospital or an ICHSC.

Watch for: G365 rules apply, including its interval limits and no coverage under age 25; not payable with E432.

Code

E430A

Description

Pap Smear Tray Fee (G365)

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Add-on to G365 (or to the visit that included the Pap) when a cervical cancer screening specimen is collected outside hospital or an ICHSC.

What it covers

E430 is a premium added when cervical cancer screening specimens are collected outside a hospital or ICHSC, in the office for example (J46).

It is payable when the requirements for G365 are met (J47 commentary). E431 is the matching add-on for G394, the additional screening specimen for listed follow-up reasons (J47).

Billing rules

• Payable only when the specimen is collected outside hospital or an ICHSC (J46).
• Add it to G365, or to the consultation, assessment, re-assessment or postnatal visit when the pelvic exam was part of that service. In that case G365 itself isn't payable but E430 is (A4, J47 rules 4–5).
• With an insured colposcopy, G365 isn't payable but E430 can still be added (J47 rule 5).
• The G365 limits apply: once per patient per 33 months for services from March 3, 2025 to March 31, 2028, and once per 54 months from April 1, 2028 (J47).
• G365 is uninsured for patients under 25 (J47).
• Not payable with E432, the speculum pelvic exam add-on to A001/A007 (A4).
• In long-term care, E430 is included in the W010 monthly management fee for that patient and month (GP51).

Often billed with

• G365 cervical cancer screening specimen collection (J46).
• A consultation, general or specific assessment or re-assessment, or routine postnatal visit that included the pelvic exam, in place of G365 (A4, J47).
• G700 sole-reason premium when G365 is the only reason for the visit, since G365 is marked '+' (J3, J46).

Common rejections

• VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
• A2A: OHIP judged the patient outside the age range; cervical screening (G365) is uninsured under age 25, and E430 follows G365's requirements (J47; A2A guide).
• EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).
• EQ6: The referring provider number on the claim isn't registered with the Ministry; check or remove the referring number.
• VH8: The date of birth doesn't match OHIP's record for the health number; correct it and resubmit (VH8 guide).

Related codes: G365, E431, G394, E432, A007, G700

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Gynaecology, pages J46–J47; note on page A4.

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