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Billing code

H101A — Minor Assessment (Day)

ED minor assessment, weekday day

Bill H101 for a minor ED assessment, a brief history and exam of one area or brief advice, weekdays 08:00 to 17:00.

Watch for: Special visit premiums aren't payable with ED H-codes; bill H103 or H102 when their requirements are met.

Code

H101A

Description

Minor Assessment (Day)

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

ED minor assessment (brief history and exam of one part, or brief advice) by the ED physician on duty, weekday daytime band.

What it covers

A minor assessment includes a brief history and examination of the affected part or region (or related to a mental or emotional disorder), and/or brief advice or information about health maintenance, diagnosis, treatment or prognosis (GP27).

In the ED or a Hospital Urgent Care Clinic, the ED physician bills it with this code for the Monday to Friday daytime (08:00 to 17:00) time band (A16).

Billing rules

• Use H-prefix ED codes when you are working a scheduled ED or Hospital Urgent Care Clinic shift, or when you are on call and the visit doesn't qualify for a special visit premium. Any physician on duty, whatever the specialty, must use these codes (GP50).
• Add E420 (+50%) for a trauma patient whose Injury Severity Score is above 15 (age 16+) or above 12 (under 16), recorded in the chart, on the day of the trauma or within 24 hours. Submit it on the same claim (GP109).
• Special visit premiums are not payable with H-prefix ED codes (GP65).
• Not payable fee-for-service in an ED covered by an alternative funding agreement, except under the AFA's second on-call or GP Expert group numbers (GP110).
• Pick the assessment level by what was done: multiple systems (H103) or comprehensive (H102) when their requirements are met (A15, A16).

Often billed with

• H264 pelvic exam with speculum, payable in addition to an assessment (A18).
• E420 trauma premium when the patient qualifies (GP109).

Common rejections

• ESD: The hospital ED is part of an alternative funding agreement, so H-prefix services there aren't paid fee-for-service unless billed under the AFA's second on-call or GP Expert group number (GP110).

Related codes: H102, H103, H104, H131, H151, H121

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00) – Emergency Department Physician, page A16; definitions A15, GP50.

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