OHIP billing code for Pap test

Updated October 26, 2026

The OHIP billing code for a Pap test (now cervical cancer screening specimen collection) is G365A, $12.00, plus E430A, $11.95, when it's done outside a hospital. Add G700A when the screening is the only reason for the visit. Patients must be 25 or older, once per 33 months.

Code	What it is	Fee	When to bill it
G365A	Collection of cervical cancer screening specimen(s)	$12.00	Routine screening, alone or with a minor or intermediate assessment or an adult periodic health visit.
E430A	Screening specimen collected outside hospital, to G365	$11.95	Add when collected in the office or anywhere outside a hospital or ICHSC. Also the only payable code when screening is part of a general assessment or consultation.
G394A	Additional cervical screening specimen(s)	$12.00	Only for the follow-up reasons listed in the Schedule, such as a repeat after an invalid HPV test, or every 3 years for immunocompromised patients.
E431A	Additional specimen collected outside hospital, to G394	$11.95	Add to G394 when collected outside a hospital or ICHSC.
G700A	Sole-reason visit premium	$8.80	When collecting the specimen is the only reason for the visit.

How to bill it

Screening is the only reason for the visit: G365A + E430A + G700A (J3, J46).

With a minor assessment, intermediate assessment or adult periodic health visit (A001, A007, K131, K132): bill the visit + G365A + E430A (OMA cervical screening guide, section C).

With a consultation, general assessment or re-assessment (A003, A004), specific assessment or routine postnatal visit, where a pelvic exam is a normal part of the service: G365 is included, so bill the visit + E430A only (A4, J47).

Use G394A + E431A instead of G365A + E430A only for the follow-up indications listed on page J47, and chart the indication (J47, J48).

Billing rules

Uninsured for patients under 25 (J47).
Services from March 3, 2025 to March 31, 2028: G365 once per patient per 33 months. From April 1, 2028: once per 54 months (J47).
G394 needs the clinical indication documented in the chart; post-hysterectomy vault testing is once per lifetime (J47, J48).
Not payable with an insured colposcopy (Z730, Z731, Z787); E430 or E431 can still be added (J47).
E430 and E431 can't be billed with E432, the pelvic exam add-on (A4).
FHO: G365 is a Schedule 2B core service, so for enrolled patients shadow billing is 50% of the fee (Agreement p.59 §4.3–4.4).
FHO and FHN physicians aren't eligible to claim the cumulative preventive care bonus for cervical screening (INFOBulletin 260302).

Common rejections

A2A: The patient is under 25, or the date of birth on the claim is wrong. G365 is uninsured under age 25 (J47).
A2B: OHIP's description is 'service not usually performed for the patient's sex'. Check the sex and health number on OHIP's record for the patient.
D7: On the remittance advice: G365 or G394 billed with a colposcopy (Z730, Z731, Z787) the same day pays $0 (OMA cervical screening guide; J47).

Questions

What is the OHIP billing code for Pap test?

Can I bill G365 with a periodic health visit?

Yes. With an adult periodic health visit (K131 or K132), a minor or an intermediate assessment, bill G365 and E430 as well. With a general assessment (A003) or a consultation, bill only E430 (OMA cervical screening guide, section C; A4, J47).

Can I bill a Pap test for a patient under 25?

No. G365 is uninsured for patients under 25 (J47). If the patient asks for screening outside the insured interval or age, it is an uninsured service the patient pays for.

Is a speculum exam for an STI check billed as G365?

No. G365, G394, E430 and E431 are only for collecting cervical cancer screening specimens. For an internal exam done for another reason, use the assessment and, with A001 or A007 in the office, E432 (OMA cervical screening guide, section F; A4).

Sources

All OHIP billing codes by service · See how APEX works · Pricing