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A007, K005, A003 & More: Which OHIP Codes Can You Bill on the Same Visit?

"Can I bill this with that?" is one of the most common questions in Ontario family medicine billing. It's also one of the easiest ways to lose money or trigger a rejection if you guess wrong.

We pulled the combination questions Ontario family doctors are searching most, based on our own billing matrix and the code pairs that show up again and again in claims. Here are the top 5.

1. A007 + K005: Yes, if the diagnoses are different

This is the most-searched combination in family medicine billing, and for good reason: it comes up constantly. You can bill an Intermediate Assessment (A007) and Primary Mental Health Care (K005) on the same visit, but only when they address clearly different diagnoses.

  • Use a different diagnostic code for each service.
  • K005 is time-based and requires a minimum of 20 minutes of direct contact — document your start and stop times.
  • A combined visit should run at least 25 minutes to comfortably cover both components.
  • Ensure that you create two separate bill books for each of the codes.

Example: a patient comes in for hypertension follow-up (A007, Dx 401) and also wants to discuss new-onset anxiety (K005, Dx 300). Two different problems, two different diagnostic codes: bill both.

2. A003 + K005: Same rule, higher-value visit

The General Assessment (A003) pairs with K005 the same way A007 does: different diagnoses, documented times, separate diagnostic codes. Because A003 pays more than A007, a well-documented A003 + K005 visit is one of the higher-value combination bills in general practice (as long as the visit genuinely covers a comprehensive assessment and a distinct mental health concern). Just like the rule above, ensure that you create two separate bill books for each of the codes.

3. G365 + E430: Pap plus tray, billed together

For routine cervical screening, the pap test (G365) and the tray fee (E430) are billed together as a pair, and this combination is compatible with most assessment codes (A001, A007, K131, K132). Two things trip people up:

  • Abnormal or follow-up paps use G394 + E431 instead, not G365/E430.
  • Tray-only billing (no pap) applies in specific scenarios like A003, A004, A008, or P008 visits where a pap isn't being done that day.

Mixing up normal vs. abnormal pap/tray codes is one of the more common quiet rejections we see, because the claim doesn't always fail outright, it just gets paid at the wrong rate.

4. Annual Health Exam + E079/K039: Check for smoking cessation

For any annual health exam such as K017, K130, K131, or K132, you can add on the code for smoking cessation: E079 if it's the first check and K039 if it's the subsequent.

  • All periodic health exams are eligible except for K133 (Periodic Developmental Disability)
  • As a reminder, E079/K039 is not eligible with K030 or K037 (Fibromyalgia)
  • K013 may be combined with E079/K039 but K033 may NOT be combined with E079/K039

5. Q040: The one that must be billed alone

Not every "combination" question has a yes answer. The Diabetes Management Incentive (Q040) cannot be combined with A/K codes, smoking cessation codes, pap/tray codes, or post-hospital codes: it must be submitted as a standalone claim, the day after your third K030 (Diabetes Management) visit in a 12-month period. Bundling Q040 onto the same claim as an assessment is one of the most common reasons this incentive gets rejected instead of paid.

What changed since FHO+ (April 2026)

FHO+ didn't rewrite the compatibility rules for standard A- and K-prefix codes (those pairing rules above are unchanged). What did change:

  • Fee increases of roughly 10–14% across most codes, reflecting the PSA Year 3 relativity adjustment.
  • Higher shadow billing rates for FHO physicians on top of the base fee increases.
  • The new Q310–Q313 hourly codes sit alongside your regular A/K billing; they don't replace or change how A007, K005, A003, or any other assessment code combines with the rest of your billing.

If you're also navigating the new hourly codes, see our FHO+ billing guide for how Q310–Q313 fit into your day.

Stop guessing at combinations

Every one of these rules, which codes pair, which diagnoses need to differ, which combinations must stand alone, is exactly the kind of thing Quip checks automatically before your claim ever leaves the EMR. No memorizing pairing tables, no manual cross-referencing.

Book a demo to see how Quip flags compatible and incompatible code combinations in real time, right inside PS Suite or Accuro.

Quip Medical builds AI-powered OHIP billing optimization for Ontario physicians. This post reflects billing rules as of July 2026; always confirm current requirements with the OMA Schedule of Benefits.