H123 – Multiple systems assessment
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A multiple systems assessment rendered for an unscheduled patient in an emergency department or Hospital Urgent Care Clinic. This service is specifically for visits that occur during night hours, from 00:00h to 08:00h. This service must be rendered by an Emergency Department Physician, defined as a physician: a. working in a hospital emergency department specifically for the purpose of rendering services to unscheduled patients who attend the emergency department to receive physician services; or b. working in a Hospital Urgent Care Clinic specifically for the purpose of rendering services to unscheduled patients who attend the Hospital Urgent Care Clinic to receive physician services. These 'H' prefix listings apply when a full- or part-time Emergency Department Physician is working for a pre-arranged designated period of time or shift, or for services rendered by an on-call physician where the service does not qualify for claiming a special visit premium (see ).
When to Use
- Use H123 for a multiple systems assessment performed by an ED physician on an unscheduled patient between 00:00h and 08:00h.
- Use this code when you are working a pre-arranged ED shift and the patient encounter does not qualify for a special visit premium under GP65.
- Use H123 instead of standard A-prefix assessment codes when you are acting as the designated ED physician for the facility.
Common Pitfalls
- Attempting to bill a special visit premium alongside H123 is a common rejection error, as H-prefix codes are explicitly excluded from these premiums.
- Billing H123 for services rendered outside the 00:00h to 08:00h window; use H103, H133, or H153 depending on the specific assessment criteria and time.
- Failing to recognize that most ultrasound services are ineligible for payment when billed by an ED physician alongside H123, with the exception of H100 or J149.
Billing Tips
- Ensure you apply the 15% age premium for patients 65 and older, as it is specifically eligible for H123.
- If you perform a major trauma intervention, remember that the E420 trauma premium can be applied to H123 provided the ISS score is documented in the chart.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
With the exception of ultrasound guidance, (J149) or emergency department investigative ultrasound (H100), ultrasound services listed in this Schedule rendered by an Emergency Department Physician are not eligible for payment.
When any other service is rendered by the Emergency Department Physician in premium hours (and assessments may not be claimed), apply one of the following premiums per patient visit. - H112: nights (00:00h to 08:00h) - H113: daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays and Friday Evenings (17:00h to 24:00h) - H114: evenings (17:00h to 24:00h) on Mondays to Thursdays
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