A917 – Sport medicine focused practice assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A focused practice assessment rendered by a GP/FP physician with additional training and/or experience in sport medicine. The assessment must satisfy, at a minimum, all of the requirements of an intermediate assessment.
When to Use
- Billing for a comprehensive assessment of a new sports-related injury (e.g., ACL tear, rotator cuff strain) where the physician has sport medicine training, even if the patient is not referred by another physician.
- Using A917 for a follow-up assessment of a chronic sports condition (e.g., osteoarthritis exacerbated by sport) that requires a detailed evaluation beyond a simple intermediate assessment (A007).
- Billing for an assessment of a young athlete presenting with a complex musculoskeletal issue that requires specialized sport medicine knowledge, distinct from a general intermediate assessment (A007).
Common Pitfalls
- Billing A917 when the service provided is essentially an intermediate assessment (A007) without the specialized sport medicine focus or required additional training/experience.
- Failing to meet the minimum 30-minute service delivery requirement for A917, leading to claims being rejected or audited.
- Billing A917 on the same day as another consultation, assessment, visit, or counselling service (e.g., A007, K013) to the same patient by the same physician, violating same-day restrictions.
Billing Tips
- Ensure your documentation clearly reflects the sport medicine focus of the assessment, detailing the specific sport-related history, examination findings, and management plan, beyond the standard requirements for an intermediate assessment (A007).
- Be prepared to provide evidence of your sport medicine training or experience to the ministry upon request, as this is a key requirement for using code A917.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultations and Visits
Assessment
Must satisfy all requirements of an intermediate assessment (A007).
Intermediate assessment requirements include: history of the presenting complaint(s), inquiry concerning, and examination of the affected part(s), region(s), system(s), or mental or emotional disorder as needed to make a diagnosis, exclude disease, and/or assess function.
Must include common elements of assessments: direct physical encounter, history, physical examination, inquiry to arrive at an opinion, making arrangements for follow-up care, and providing advice/information to the patient.
A minimum of 30 minutes of service delivery is required before detention is payable.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.