< Billing codes

Billing code

H131A — Minor Assessment (Evening)

ED minor assessment, weekday evening

Bill H131 for a minor ED assessment, a brief history and exam of one area or brief advice, Monday to Thursday 17:00 to 24:00.

Watch for: If you only did a procedure and no assessment can be claimed, bill the H114 premium instead.

Code

H131A

Description

Minor Assessment (Evening)

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, Monday to Thursday evening 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 Thursday evenings (17:00 to 24:00) 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).
• If you only do a procedure in premium hours and no assessment can be claimed, use the H112, H113 or H114 premium instead of an assessment (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: H132, H133, H134, H101, 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.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing