Billing code
K028A — STD Management (max 2units/pt/doc/day & 4 units/pt/doc/yr)
STI or needle-stick counselling
Bill K028 per half-hour unit to assess and counsel a patient with a suspected sexually transmitted infection or blood-borne pathogen exposure.
Watch for: Not payable with any visit by you that day; maximum 2 units per day and 4 per year per patient.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $80.00 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- K028A
- Description
- STD Management (max 2units/pt/doc/day & 4 units/pt/doc/yr)
- 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
STI or potential blood-borne pathogen management: time-based assessment and counselling, billed per unit, max 2 units a day and 4 a year.
What it covers
K028 is an all-inclusive, time-based service for assessing and counselling a patient suspected of having a sexually transmitted infection, or a patient with a potential blood-borne pathogen exposure such as a needle-stick injury (A52).
Billing rules
- Not payable with any consultation, assessment or visit by you on the same day (A52).
- Maximum 2 units per patient per physician per day, and 4 units per patient per physician per year (A52).
- Units are ½ hour or major part: 1 unit = at least 20 minutes, 2 units = 46, 3 units = 76, 4 units = 106, then every 30 minutes more (GP55).
- Count consecutive time in direct contact with the physician in person, excluding other separately billed services and chart work (GP54, GP55).
- Record start and stop times in the chart, or the service is not eligible for payment (GP7).
- Under 20 minutes is not this service; bill the assessment you actually provided (GP55).
- May be given by video or phone as comprehensive virtual care with an existing relationship; add K300A or K301A (Appendix J AJ1, A70).
Often billed with
- E080 first visit after hospital discharge, office or home, within 2 weeks of an acute in-patient discharge (GP28).
Common rejections
- AT3: Usually means it was billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person visit with you in the past 24 months (AT3 guide; A66).
- EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).
- VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
- VH8: The date of birth doesn't match OHIP's record for the health number; correct it and resubmit (VH8 guide).
- R02: The health number on the claim is invalid; check it against the patient's card and resubmit.
Related codes: K013, K022, A007
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A52.
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