OHIP billing code for shingles vaccine

Updated October 26, 2026

There is no shingles-specific OHIP code, so bill G538A, other immunizing agents not listed above, $8.80, for each dose. Add G700A ($8.80) when the vaccine is the only reason for the visit.

Code	What it is	Fee	When to bill it
G538A	Other immunizing agents not listed above	$8.80	Each shingles vaccine dose.
G700A	Basic fee-per-visit premium for (+) procedures	$8.80	The vaccine (alone or with other (+) procedures) is the only reason for the visit.

How to bill it

Bill G538A for each dose, with diagnostic code 896 (immunization).

If the shot was the only reason for the visit, add G700A. If you also bill an assessment for the visit, leave G700A off.

Bill the second dose the same way at its own visit.

Billing rules

G538 is for immunizing agents not specifically listed; shingles (herpes zoster) vaccine has no code of its own on J54 (J54).
Marked (+): when the vaccine is the only reason for the visit, add G700, once per patient per day however many vaccines or (+) procedures are given (J3, J54).
G700 is not payable in hospital, and is paid at 15% of its fee for patients enrolled to a physician or group paid mainly by capitation (J3).
When the vaccine is given at a visit where you bill an assessment, such as A007, don't add G700: the vaccine isn't the only reason for the visit (J3).
May be delegated to trained staff you employ, even when you aren't on site, for your own patient; the chart must be dated and name who gave it. Not payable when the person giving it is employed by a hospital, public health unit, long-term care home or Family Health Team (GP62–GP63).
Payable on the same day as a counselling service by the same physician (GP58).
The Schedule notes an immunization may be uninsured in some circumstances and points to section 24 of Regulation 552 (J54, AA1). For example, immunization given only for travel outside Canada is uninsured (Reg. 552 s.24(1) para 25).
There is no Q-code replacement for G700 with this vaccine: Q590A is only for flu shots (AQ3).
FHO: G538A is on the list of in-basket services that get the 50% blended fee-for-service premium for enrolled patients from April 1, 2026 (INFOBulletin 260502).

Diagnostic codes

896: Immunization, all types

Common rejections

D8: OHIP's description is 'Allowed with specific procedures only'. G700 is payable only with a (+) procedure, and the Ministry has said G700 is refused with D8 when it isn't on the same claim as the immunization code (J3; INFOBulletin 4544).

Questions

What is the OHIP billing code for shingles vaccine?

There is no shingles-specific OHIP code, so bill G538A, other immunizing agents not listed above, $8.80, for each dose. Add G700A ($8.80) when the vaccine is the only reason for the visit.

Who gets a free shingles vaccine in Ontario?

Ontario's routine schedule lists shingles as a 2-dose series between age 65 and 70 (Ontario.ca routine immunization schedule, updated August 2026).

Sources

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