G700 – Basic fee-per-visit premium for procedures marked (+)
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
When a procedure(s) is the sole reason for a visit, add G700, the basic fee-per-visit premium for those procedures marked (+) regardless of the number of procedures carried out during that visit.
When to Use
- Use G700 when performing a minor procedure marked with a (+) in the Schedule of Benefits, such as a simple excision or biopsy, as the primary reason for an office visit.
- Apply G700 when multiple (+) procedures are performed during a single office visit, as it covers the entire encounter regardless of the number of procedures completed.
Common Pitfalls
- Billing G700 for procedures performed in a hospital setting, which is strictly prohibited by the Schedule of Benefits.
- Attempting to claim G700 alongside an assessment or consultation code (e.g., A007 or A005), as these are restricted code classes and will trigger a rejection.
- Submitting G700 when the underlying (+) procedure is ineligible for payment, as the premium is contingent on the successful payment of the primary procedure.
Billing Tips
- Ensure the procedure code used is explicitly marked with a (+) in the Schedule of Benefits, as G700 is invalid for procedures lacking this specific designation.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Premium
Diagnostic and Therapeutic Procedures, Other Premiums (including After Hours Procedure Premiums)
G700 is not eligible for payment for a service provided in a hospital.
G700 is not eligible for payment when the service marked with (+) is not eligible for payment.
G700 is payable at 15% of the listed fee when the service is rendered to a patient who has signed the Ministry's Patient Enrolment and Consent to Release Personal Health Information form and who is enrolled to a physician or group of physicians who are signatories to a Ministry alternate funding plan agreement paying physicians primarily by capitation rather than fee for service, applicable regardless of which physician of the group renders the service to the enrolled patient.
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