What are the billing rules for E431A?

Payable only when the specimen is collected outside hospital or an ICHSC, and only when the G394 requirements are met, including a charted clinical indication (J47, J48). When collection is part of a consultation, repeat consultation, general or specific assessment or re-assessment, or routine postnatal visit that includes a pelvic exam, G394 isn't payable but one of E430 or E431 may be added to that visit (A4, J47). With an insured colposcopy, G394 isn't payable but one of E430 or E431 may still be added (J47).

What is E431A often billed with?

G394 additional cervical cancer screening specimen (J47). A consultation, general assessment or re-assessment, or routine postnatal visit that included the pelvic exam, in place of G394 (A4, J47). Q011A, the zero-fee Pap smear tracking code used by preventive care bonus models such as FHO and FHN (OMA Q-codes guide pp.7, 18).

Why is E431A rejected?

A2B: OHIP describes this as 'Service not usually performed for the patient's sex': the code didn't match the sex on the patient's OHIP record; check the health number and patient details on the claim.

< Billing codes

Billing code

E431A — Pap Smear Tray Fee (G394)

Q: What is OHIP billing code E431A?

Add-on to G394 when the additional cervical cancer screening specimen is collected outside hospital or an ICHSC, such as in the office.

Office extra Pap test premium

Add to G394 when an additional cervical screening specimen is collected outside hospital or an ICHSC, such as in the office.

Watch for: G394 requirements must be met, including a charted clinical indication; not payable with E432.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$11.95	$0.00	$0.00	$0.00	$0.00

Code: E431A
Description: Pap Smear Tray Fee (G394)
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 G394 when the additional cervical cancer screening specimen is collected outside hospital or an ICHSC, such as in the office.

What it covers

E431 is the premium for collecting an additional cervical cancer screening specimen outside a hospital or ICHSC, added to G394 (J47). It is payable when the requirements for G394 are met (J47).

E430 is the matching add-on for routine screening under G365 (J46, J47).

Billing rules

Payable only when the specimen is collected outside hospital or an ICHSC, and only when the G394 requirements are met, including a charted clinical indication (J47, J48).
When collection is part of a consultation, repeat consultation, general or specific assessment or re-assessment, or routine postnatal visit that includes a pelvic exam, G394 isn't payable but one of E430 or E431 may be added to that visit (A4, J47).
With an insured colposcopy, G394 isn't payable but one of E430 or E431 may still be added (J47).
Not payable with E432, the speculum pelvic exam add-on to A001/A007 (A4).
In long-term care, E431 is included in the W010 monthly management fee for that patient and month (GP51).

Often billed with

G394 additional cervical cancer screening specimen (J47).
A consultation, general assessment or re-assessment, or routine postnatal visit that included the pelvic exam, in place of G394 (A4, J47).
Q011A, the zero-fee Pap smear tracking code used by preventive care bonus models such as FHO and FHN (OMA Q-codes guide pp.7, 18).

Common rejections

A2B: OHIP describes this as 'Service not usually performed for the patient's sex': the code didn't match the sex on the patient's OHIP record; check the health number and patient details on the claim.

Related codes: G394, E430, G365, E432, Q011

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Gynaecology — Cervical cancer screening, pages J46–J48; note on page A4

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