OHIP billing code for STI testing

Updated October 26, 2026

There is no single OHIP code for STI testing. Bill the visit, usually A007A intermediate assessment, or K028A, the time-based STI management code ($80.00 per half-hour unit) for assessment and counselling of a patient suspected of having an STI; the lab bills for the tests themselves.

Code	What it is	Fee	When to bill it
K028A	STI or potential blood-borne pathogen management, per unit	$80.00	Time-based assessment and counselling (at least 20 minutes) of a patient suspected of having an STI, or after a potential blood-borne pathogen exposure such as a needle-stick.
A007A	Intermediate assessment	$44.55	A regular visit for STI symptoms or testing.
E432A	Pelvic exam with speculum outside hospital, add to A001 or A007	$5.00	You do a speculum exam in the office at that visit.
G489A	Venipuncture, adolescent or adult (16 and over)	$3.54	You draw blood in the office, for example for HIV or syphilis testing.

How to bill it

For a regular visit, bill the assessment you provided (usually A007A) with the STI diagnostic code. Add E432A if you did a speculum pelvic exam in the office.

If you spent at least 20 minutes on assessment and counselling for a suspected STI, you can bill K028A instead, by time units, with start and stop times charted. Don't bill an assessment the same day as K028A.

If you draw blood in the office, add G489A (age 16 and over).

Use diagnostic code 099 (other STIs, such as chlamydia or genital herpes), 098 (gonococcal infections) or 097 (syphilis). Code 100 was deleted on March 13, 2026.

Billing rules

K028 is an all-inclusive, time-based service for assessment and counselling of a patient suspected of having an STI, or with a potential blood-borne pathogen exposure (A52).
K028 isn't payable with any consultation, assessment or visit by the same physician on the same day (A52).
K028 is limited to 2 units per patient per physician per day and 4 units per patient per physician per year (A52).
Units are half-hours or major part: 1 unit is at least 20 minutes, 2 units 46, 3 units 76, 4 units 106. Chart start and stop times or the service isn't payable (GP7, GP55).
K028 can be given by video or phone as comprehensive virtual care with K300A or K301A when you have an existing relationship with the patient (AJ1, A70).
E432 is paid once per day, must be done personally, and isn't payable with E430, E431 or E542 (A4).
G489 is marked (+): add G700 when the blood draw is the only reason for the visit (J3, J7).
Diagnostic code 100 (venereal diseases) was deleted effective March 13, 2026 (INFOBulletin 260314).

Diagnostic codes

099: Sexually transmitted infections: other (e.g. herpes genitalis, chlamydia, chancroid)
098: Sexually transmitted infections: gonococcal infections
097: Sexually transmitted infections: syphilis, all sites and stages

Common rejections

AT3: No patient-physician relationship. K028A was billed by video or phone (K300A/K301A) but OHIP found no in-person service in the last 24 months and no enrolment to you or your group (A66).
V22: Invalid diagnostic code. Diagnostic code 100 was deleted on March 13, 2026 (INFOBulletin 260314); use 097, 098 or 099.

Questions

What is the OHIP billing code for STI testing?

Do I bill anything for the swabs or urine test?

The lab bills the tests under the Schedule of Benefits for Laboratory Services. You bill your visit (A007A or K028A), plus G489A if you draw blood in the office.

Can I bill K028A for a needle-stick injury?

Yes. K028 also covers assessment and counselling of a patient with a potential blood-borne pathogen exposure, for example after a needle-stick injury (A52).

Sources

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