All codes
A058
A058 – Partial Assessment - Community Medicine
OHIP General Listings Code — Community Medicine (05) · Schedule of Benefits
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record of the encounter.
When to Use
- Bill A058 for a brief follow-up visit where a patient presents with a new, distinct complaint that requires a focused history and physical exam, separate from their ongoing chronic condition management.
- Use A058 when a patient requires a quick assessment for a minor acute issue, such as a mild rash or a brief bout of nausea, where a full assessment (A053) is not warranted.
- A058 is appropriate for a patient presenting for a specific, limited problem that requires a history, examination, and advice, but does not meet the criteria for a comprehensive consultation (A055).
Common Pitfalls
- Billing A058 for routine follow-up of a chronic condition; these visits are typically billed with assessment codes like A007 or A008.
- Submitting A058 when the patient's complaint is identical to a previously assessed issue on the same day, as only one assessment per diagnosis per day is generally permitted.
- Claiming A058 for services that do not include a direct physical examination or patient advice, which are mandatory components of this code.
Billing Tips
- Ensure the patient's chart clearly documents the specific presenting complaint, the limited physical examination performed, and the advice provided to justify the A058 billing.
- A058 is not payable for specialty 05 (Community Medicine) itself, but rather for specific specialties listed in GP25; verify your specialty's eligibility before billing.
Provider Fee$0.00
Specialist Fee$38.05
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Community Medicine (05)
Service Type
Consultations and Visits
Code Classes
Assessment
Must include a direct physical encounter with the patient.
Must include a history of the presenting complaint.
Must include a necessary physical examination.
Must include advice to the patient.
A permanent medical record of the assessment must be maintained.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.