H132 – Comprehensive assessment and care
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Comprehensive assessment and care rendered by an Emergency Department Physician. As per , an 'Emergency Department Physician' is a physician working in a hospital emergency department or Hospital Urgent Care Clinic for the purpose of rendering services to unscheduled patients. This service is specifically for care provided on Monday to Friday, during the evening hours of 17:00h to 24:00h. As an assessment, this service includes the specific elements of assessments as defined in , such as a direct physical encounter, history taking, physical examination, and providing advice to the patient. It also includes the common elements of all insured services as outlined in -. An age-based premium is applicable for patients aged 65 and older as per .
When to Use
- Use H132 for a comprehensive assessment of an unscheduled patient presenting to the ED between 17:00 and 24:00 on weekdays.
- Select H132 when the clinical encounter meets the full requirements of a comprehensive assessment as defined in GP15, rather than a minor or intermediate assessment.
Common Pitfalls
- Billing a special visit premium (e.g., K963) alongside H132 will result in an automatic rejection, as 'H' prefix codes are ineligible for these premiums.
- Attempting to bill H132 for patients seen outside the 17:00-24:00 window, as this code is strictly time-gated by the Schedule of Benefits.
Billing Tips
- Always append the age premium (15%) for patients 65 and older to maximize the claim value for H132, as it is specifically eligible under GP64.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments, Hospital and Institutional Consultations and Assessments
With the exception of the consultation fee (where a specific fee code exists for a specialist in emergency medicine), any physician on duty (regardless of specialty) in the emergency department must submit using these listings.
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