E432

PDF page 132 / A4

A003 General assessment...............................................................           95.60
                   Note:
                   A003 is not eligible for payment for an assessment provided in the patient’s home.
               A004 General re-assessment ..........................................................            39.35
                   Note:
                   The collection of cervical cancer screening specimen(s) is included in the consultation, repeat
                   consultation, general or specific assessment (or re-assessment), or routine postnatal visit when
                   pelvic examination is normal part of the foregoing services. However, the add-on codes E430
                   or E431 can be billed in addition to these services when collection of cervical cancer screening
                   specimen(s) is performed outside of a hospital or ICHSC.
               A001 Minor assessment...................................................................         26.80
               A007 Intermediate assessment or well baby care ...........................                       44.55
               E432     - when pelvic exam including speculum is performed
                          outside of hospital or ICHSC, to A001 and A007 ....... add                             5.00
               A002 Enhanced 18 month well baby visit (see General Preamble
                        GP34) ................................................................................. 73.95
                   Payment rules:
                   1.Special visit premiums listed in Table VI on page GP75 of this Schedule are not eligible for
                     payment with A007 or A001 when rendered in a patient’s home.
                                          2.For A007 or A001 rendered in a patient’s home, travelling to and from the home is included
                                            as a common element of the insured service. See page GP13 of this Schedule.
                                          3.See the Definitions section of this Schedule for the definition of home.
                                          4.E432 is limited to one service per patient per day.
                                          5.E432 is only eligible for payment when the procedure is personally rendered by the
                                            physician.
                                          6.E432 is not eligible for payment with E430, E431, or E542.
                 Mini assessment
                   A mini assessment is rendered when an assessment of a patient for an unrelated non-WSIB
                   problem is performed during the same visit as an assessment of a WSIB related problem for
                   which only a minor assessment was rendered.
               A008 Mini assessment ..................................................................... 13.40
                   [Commentary:
                   A008 is only payable when the WSIB component of the visit is the service described as A001.
                   In circumstances where a different service or a higher level of assessment is claimed, A008 is
                   not payable in addition.]

PDF page 278 / A150

CONSULTATIONS AND VISITS
      OBSTETRICS AND GYNAECOLOGY (20)
         GENERAL LISTINGS
       A205 Consultation* ..........................................................................                           134.25
       A935 Special surgical consultation (see General Preamble GP19).                                                         194.65
       A206 Repeat consultation* ..............................................................                                 71.45
       A203 Specific assessment*..............................................................                                  62.65
       A204 Partial assessment .................................................................                                40.50
       E432   - when pelvic exam including speculum is performed
                outside of hospital or ICHSC, to A203, A204, A205 and
                A206.......................................................................... add                                5.00
                                          Payment rules:
                                          1.The collection of cervical cancer screening specimen(s) is included in the consultation,
                                            repeat consultation, general or specific assessment (or re-assessment), or routine post-natal
                                            visit when pelvic examination is normal part of the foregoing services. However, the add-on
                                            codes E430 or E431 can be billed in addition to these services when collection of cervical
                                            cancer screening specimen(s) is performed outside of a hospital or ICHSC.
                                          2.E432 is limited to one service per patient per day.
                                          3.E432 is only eligible for payment when the procedure is personally rendered by the
                                            physician.
                                          4.E432 is not eligible for payment with E430, E431, or E542.
                                   EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
                                    Physician in hospital but not on duty in the Emergency Department when seeing patients in the
                                    Emergency or OPD - use General Listings.
                 NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
                  See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
                  patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
                  GP78.
               C205 Consultation* .......................................................................... 134.25
               C935 Special surgical consultation (see General Preamble GP19).                               194.65
               C206 Repeat consultation* ..............................................................       71.45
               C203 Specific assessment*..............................................................        62.65
               C204 Specific re-assessment* .........................................................         44.30
                 Subsequent visits
               C202 - first five weeks........................................................ per visit                         31.00
               C207 - sixth to thirteenth week inclusive (maximum 3 per patient
                      per week)................................................................ per visit                        31.00
               C209 - after thirteenth week (maximum 6 per patient per month)
                       ............................................................................... per visit                 31.00
                 Subsequent visits by the Most Responsible Physician (MRP)
                  See General Preamble GP44 to GP45 for terms and conditions.
               C122 - day following the hospital admission assessment..............                                              71.80
               C123 - second day following the hospital assessment ..................                                            71.80
               C124 - day of discharge .................................................................                         71.80
               C126 - day of discharge, medically complex patient (see A13 for
                      terms and conditions) .........................................................                            95.10

Master, record 1160. Record Layout PDF, page 1.

E43220260401999999990000005000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.