Billing code
P002A — High Risk Prenatal Assessment
High-risk prenatal assessment
Bill P002 when a maternal-fetal medicine specialist spends at least 20 minutes with a patient whose pregnancy has documented significant maternal or fetal risk.
Watch for: Record start and stop times in the chart, or the assessment isn't payable.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $87.25 | $0.00 | $0.00 | $0.00 |
- Code
- P002A
- Description
- High Risk Prenatal Assessment
- 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
A maternal-fetal medicine specialist's assessment of 20+ minutes for a pregnancy with documented significant maternal or fetal risk.
What it covers
A high risk prenatal assessment is an assessment by a maternal-fetal medicine specialist, with at least 20 minutes in direct contact with the patient, to manage documented significant maternal and/or fetal risk factor(s) where the mother and/or fetus are at significant risk of serious complications (K4).
Prenatal visits are assessments and include pregnancy-related counselling (K1, K2).
Billing rules
- Payable to a maternal-fetal medicine specialist (K4).
- Needs at least 20 minutes of direct patient contact (K4).
- Record start and stop times in the chart, or it is not payable (K4).
- Document the significant maternal and/or fetal risk factor(s) (K4).
Related codes: P003, P004, P005, A205, A206
Source: Schedule of Benefits (July 1, 2026), Obstetrics, Prenatal Care, page K4.
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