G315 – Maximal stress ECG - technical component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Maximal stress ECG (exhaustion, symptoms or ECG changes) or submaximal stress ECG (to target heart rate for patient) by a standard technique - with treadmill or ergometer and oscilloscopic continuous monitoring including ECGs taken during the procedure and resting ECGs before and after the procedure - physician must be in attendance at all times. The professional component is billed as G319 and includes the necessary clinical assessment immediately prior to testing. The technical component is only eligible for payment where: 1. the physician has the necessary training and experience to personally render the technical component of the service; and 2. the physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
When to Use
- Use G315 in conjunction with G319 when performing a diagnostic exercise stress test for symptomatic patients with suspected coronary artery disease.
- Use G315 when you personally provide the treadmill or ergometer equipment and continuous oscilloscopic monitoring in an office setting, provided you maintain documented quality assurance protocols.
Common Pitfalls
- Billing G315 for routine preoperative cardiac clearance in low-risk patients is ineligible for payment and will trigger audit scrutiny.
- Attempting to bill G315 for asymptomatic patients with a 10-year coronary heart disease risk under 10% is prohibited as these are considered uninsured services.
- Failing to bill the professional component G319 separately results in under-billing, as G315 only covers the technical equipment and monitoring component.
Billing Tips
- Ensure your office maintains a written quality assurance manual for the testing equipment to satisfy the specific documentation requirement for the technical component.
- If performing this test in a hospital setting, be aware that the payment for G315 is automatically adjusted to 86.10% of the listed fee.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
The physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
1. The technical and professional fee components for maximal stress ECG are not eligible for payment in the routine preoperative preparation or screening of a patient for surgery where the patient will undergo a low risk procedure or has a low risk of perioperative cardiac complications, unless there is a clinical indication requiring a exercise stress test study other than solely for preoperative preparation of the patient.
2. G315, G319, G174, G111 and G112 are uninsured services for routine annual stress tests in asymptomatic patients where the patient's 10 year risk of coronary heart disease is less than 10% calculated by generally accepted methodology.
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