Definitions of OHIP health examination fee codes
| OHIP FEE CODE | DEFINITION* |
|---|---|
| A003 | A general assessment: a family practice service provided somewhere other than the patient’s home that includes a full history (including medical, family, and social history) and, except for breast, genital, or rectal examination where refused or not medically indicated, an examination of all body parts |
| A003 with diagnostic code 917 | A general assessment billable annually for a health examination of an adolescent or adult (< 65 y) |
| A003 with diagnostic code 319 | A general assessment for a person with IDD |
| K131 (in use after January 1, 2013) | A periodic health visit: a general assessment of an individual who has no apparent physical or mental illness and which takes place after the second birthday. It might include instructions to the patient or parents regarding health care |
IDD—intellectual and developmental disability, OHIP—Ontario Health Insurance Plan.
↵* All definitions are from the Ontario Ministry of Health and Long-Term Care Resource Manual for Physicians.15