All codes
A310
A310 – Medical specific re-assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A medical specific re-assessment is a service rendered by a specialist (specifically Physical Medicine & Rehabilitation) that requires a full, relevant history and physical examination of one or more systems.
When to Use
- Use A310 for a follow-up visit where a specialist in Physical Medicine & Rehabilitation performs a relevant history and physical exam for a condition previously assessed, such as evaluating a patient's progress after a stroke rehabilitation program.
- Bill A310 when a patient requires a re-evaluation of a specific neurological condition, like assessing changes in spasticity or motor function following a course of botulinum toxin injections.
- A310 is appropriate for reassessing a patient's response to a new brace or assistive device prescribed for a chronic musculoskeletal issue, including a relevant history and physical examination.
Common Pitfalls
- Billing A310 more than twice per patient per physician within a 12-month period without meeting the hospital admission exception will result in the claim being adjusted to A318 (Partial assessment).
- Submitting A310 for a patient already in hospital, unless it's specifically for an admission assessment related to the same illness the physician saw them for prior to admission, can lead to claim rejection or adjustment.
- Using A310 when the service provided is primarily a brief follow-up or medication adjustment without a full relevant history and physical examination risks an audit or claim denial, as it does not meet the criteria for a 'medical specific re-assessment'.
Billing Tips
- Ensure documentation clearly outlines the 'relevant' history and physical examination components that differentiate this re-assessment from a routine follow-up visit (e.g., specific neurological or musculoskeletal findings).
- A310 is not eligible for age-based fee premiums (GP64), so do not attempt to bill this premium in conjunction with A310.
Provider Fee$0.00
Specialist Fee$67.80
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
Requires a full, relevant history.
Requires a physical examination of one or more systems.
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