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Billing code

H133A — ED multiple systems assessment – Monday to Thursday evening

ED multi-system assessment, weekday evening

Bill H133 for an ED assessment with a detailed history and exam of more than one system, Monday to Thursday 17:00 to 24:00.

Watch for: A later re-assessment is payable only if at least 2 hours later; special visit premiums aren't payable.

Code

H133A

Description

ED multiple systems assessment – Monday to Thursday 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 assessment with a detailed history and exam of more than one system, by the ED physician on duty, Monday to Thursday evening band.

What it covers

A multiple systems assessment is an assessment in an emergency department or Hospital Urgent Care Clinic that includes a detailed history and examination of more than one system, part or region (A15).

This code is for services in 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).
• Patients 65 and older: the fee is increased by 15% (GP64).
• A later re-assessment is payable only if it is at least 2 hours after this assessment and further care or investigation is needed and done (A15).
• 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).

Often billed with

• H134 re-assessment when the criteria are met (A15).
• H105 in-patient interim admission orders when another physician will admit the patient (A16).
• H264 pelvic exam with speculum (A18).

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, H131, H134, H103, H153, H123, H065

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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