What are the billing rules for G500A?

Limited to two per patient per lifetime (J42). Only one of G500, G514 and G520 per patient per physician per calendar month (J42, J43). Payable only to the physician most responsible for the patient's diabetes care, or a physician substituting for that physician (J42).

What is G500A often billed with?

A007 or another assessment for an in-person visit that month; a contact on the day of that visit doesn't count toward G500 (J42). G514 or G520 in the following months (J42).

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Billing code

G500A — Month In Which Insulin Injections (2 Or More Daily) Or Insulin By Pump Is Initiated; Or Month In Which Initial Assessment By A Specialist Of A Diabetic Patient Treated With Insulin Injections (2 Or More Daily) Or Insulin By Pump Occurs, 1 Or More Contacts

Q: What is OHIP billing code G500A?

Diabetes monthly management for the month insulin (2+ daily injections or pump) is started, or a specialist's first assessment month. Max 2 per lifetime.

Diabetes insulin start month

Bill G500 for diabetes management in the month twice-daily insulin or a pump is started, or a specialist's first assessment month.

Watch for: Limited to two per patient per lifetime, and only one of G500, G514 or G520 per patient per month.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$31.80	$0.00	$0.00	$0.00	$0.00

Code: G500A
Description: Month In Which Insulin Injections (2 Or More Daily) Or Insulin By Pump Is Initiated; Or Month In Which Initial Assessment By A Specialist Of A Diabetic Patient Treated With Insulin Injections (2 Or More Daily) Or Insulin By Pump Occurs, 1 Or More Contacts
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

Diabetes monthly management for the month insulin (2+ daily injections or pump) is started, or a specialist's first assessment month. Max 2 per lifetime.

What it covers

G500 pays for diabetes monthly management in the month in which insulin injections (2 or more daily) or insulin by pump are started, or the month of a specialist's initial assessment of a diabetic patient already on that regimen, with 1 or more contacts (J42).

Later months are billed as G514 (1 to 3 contacts) or G520 (4 or more contacts) (J42).

Billing rules

Limited to two per patient per lifetime (J42).
Only one of G500, G514 and G520 per patient per physician per calendar month (J42, J43).
Payable only to the physician most responsible for the patient's diabetes care, or a physician substituting for that physician (J42).
A contact is advice, by phone or otherwise, to the patient or caregiver in which a change in the frequency or dose of insulin is started, for a patient on 2 or more daily insulin injections or an insulin pump (J41).
Reviewing lab or patient-created reports, or passing on results with no change in insulin frequency or dose, doesn't count (J42).
A contact on the same day as your consultation or assessment of the patient doesn't count as a contact (J42).
The clinical decision must be yours or the substitute's; staff may pass it on (J42, J43).
A dated summary of each contact must be in the medical record (J42).

Often billed with

A007 or another assessment for an in-person visit that month; a contact on the day of that visit doesn't count toward G500 (J42).
G514 or G520 in the following months (J42).

Related codes: G514, G520, A007

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Endocrinology and Metabolism — Diabetes monthly management, pages J41–J43

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