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Billing code

G700A — Basic fee per visit Premium if sole reason for procedure/immunization

Procedure-only visit premium

Add G700 once per visit when a procedure marked (+), such as a vaccine or blood draw, is the only reason for the visit.

Watch for: Once per patient per day, not in hospital, and only with a (+) procedure; FHO physicians bill Q590A or Q593A for flu or COVID-19 shots.

Code

G700A

Description

Basic fee per visit Premium if sole reason for procedure/immunization

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

Premium added once per visit when a procedure marked (+), such as a vaccine or venipuncture, is the only reason for the visit.

What it covers

G700 is the basic fee-per-visit premium for Diagnostic and Therapeutic procedures marked (+) in the Schedule. Add it when one or more (+) procedures are the sole reason for the visit, regardless of how many are done (J3).

Common (+) codes include the immunizations G840–G849, G538, G590 and G593, venipuncture G480, G482 and G489, cervical screening G365 and G394, ear syringing G420, joint or bursa injection G370 and BCG G369 (J7, J46–J47, J53–J54, J97). Injections G372 and G373 and allergy injections G202 are not (+) (J4, J54).

Billing rules

• Payable only with a procedure marked (+), and only when the procedure(s) are the sole reason for the visit (J3).
• Once per patient per day, regardless of the number of procedures (J3, J54).
• Not payable for a service provided in a hospital (J3).
• Not payable when the (+) service itself is not eligible for payment (J3).
• Not payable when a consultation or assessment is payable to the same physician for the same patient that day and the physician has a financial interest in the facility (J3).
• Paid at 15% of the listed fee for patients enrolled to a physician or group paid mainly by capitation under a Ministry alternate funding agreement, whichever group physician sees the patient (J3).
• FHO and FHN physicians bill Q590A instead of G700 when a flu shot is the sole reason, and Q593A for a COVID-19 vaccine; only one of Q590/Q593 per patient per year (Agreement p.72 §11.7–11.8; Appendix Q AQ3, information only).

Often billed with

• Immunizations G840–G849, G538 and G590 on vaccine-only visits (J54).
• Venipuncture G489, G482 or G480 on blood-draw-only visits (J7).
• G365 cervical screening, G420 ear syringing or G370 joint injection when that is the only service (J46, J53, J97).

Common rejections

• 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.
• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).
• EH4: OHIP's record shows the patient's coverage ended before the service date; confirm the health number and service date, then the patient's coverage.
• VH8: The date of birth on the claim doesn't match OHIP's record for that health number; correct it and resubmit.

Related codes: G538, G590, G489, G365, G420, G370, G372, G373

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Preamble, page J3

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