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Billing code

G365A — Pap Smear - periodic (25-69 yo)

Cervical screening specimen collection

Bill G365 for collecting a cervical cancer screening specimen as its own service, for patients 25 and over, once per 33 months.

Watch for: Not payable with a consultation, general or specific assessment, re-assessment or postnatal visit that includes a pelvic exam; bill E430 with that visit instead.

Code

G365A

Description

Pap Smear - periodic (25-69 yo)

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Collecting a cervical cancer screening specimen as its own service, for patients 25 and over, once per 33 months (to March 2028).

What it covers

G365 pays for collecting cervical cancer screening specimen(s) when collection isn't part of another visit (J46). During a visit that normally includes a pelvic exam, collection is part of that visit (A4, J47).

G394 covers additional specimens for the follow-up reasons listed on J47, such as a repeat after an invalid HPV test or once every 3 years for immunocompromised patients.

Billing rules

• Services from March 3, 2025 to March 31, 2028: once per patient per 33-month period. From April 1, 2028: once per 54-month period (J47).
• Uninsured for patients under 25 (J47).
• Not payable with a consultation, repeat consultation, general or specific assessment or reassessment, or routine postnatal visit when a pelvic exam is a normal part of that service; bill E430 with the visit instead when collected outside hospital or an ICHSC (A4, J47).
• Not payable with an insured colposcopy service; E430 or E431 may still be billed when collected outside hospital or an ICHSC (J47).
• Marked (+): add G700 when collection is the sole reason for the visit (J3, J46).
• E432 (pelvic exam with speculum, with A001/A007) is not payable with E430 or E431 (A4).
• FHO: a Schedule 2B core service, so for enrolled patients shadow billing is 50% of the fee (Agreement p.59 §4.3–4.4, p.87).

Often billed with

• E430 when collected outside hospital or an ICHSC (J46).
• G700 when collection is the only reason for the visit (J3).
• A minor or intermediate assessment (A001/A007): G365 and E430 are still payable with it, since only consultations, general or specific assessments, re-assessments and routine postnatal visits include the collection (A4, J47).

Common rejections

• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).
• A2A: G365 is uninsured for patients under 25 (J47), so a younger patient, or a wrong date of birth on the claim, rejects as outside the age limit.
• EH2: The health card version code on the claim doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit.
• VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.
• 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: E430, G394, E431, G700, E432, A007

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Gynaecology — Cervical cancer screening, pages J46–J47

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