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A100
A100 – General/Family physician emergency department assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
An assessment of a patient that satisfies as a minimum the requirements of an intermediate assessment and is rendered by the patient's general/family physician in an emergency department funded under an Emergency Department Alternative Funding Agreement (ED-AFA).
When to Use
- Bill A100 when you are the patient's regular family physician and you assess them in an ED funded under an ED-AFA, providing at least an intermediate level of care.
- Use A100 for your initial assessment of your own patient presenting to the ED, even if they were seen by another physician in the ED prior to your assessment.
- A100 is appropriate if you are the patient's family physician and are called to the ED to assess them for a condition that is not an emergency, but requires ED resources.
Common Pitfalls
- Billing A100 for a patient who is not your regular patient; these patients should be billed using standard ED assessment codes like A007.
- Submitting A100 when the ED is not funded under an ED-AFA; in such cases, use A007 or other applicable assessment codes.
- Billing A100 in addition to other services like a special visit premium or another assessment code for the same patient during the same ED visit; A100 is inclusive of all services for that encounter.
Billing Tips
- Ensure the hospital master number for the ED is included on the claim to validate the ED-AFA status.
- If the patient is admitted and you remain the MRP, A100 serves as the admission assessment, preventing separate billing for an admission assessment code like A933.
Provider Fee$78.95
Effective: April 1, 2026
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Emergency Department Assessment
Code Classes
Assessment
Must satisfy at least the requirements of an intermediate assessment.
The physician must be the patient's regular general/family physician.
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