What is OHIP billing code A003?

A003 is "General assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A003 pay?

The current OHIP fee for A003 is $95.60, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A003 to OHIP?

A003 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A003 claims against the Schedule of Benefits rules before submission.

What codes are related to A003?

Codes related to A003 in the Schedule of Benefits include A004, A007, A001.

All codes

A003

A003 – General assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The A00x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A008 Mini assessment
A mini assessment is rendered when an assessment of a patient for an unrelated non-WSIB problem is performed during the same visit as an assessment of a WSIB related problem for…
$13.40
A001 Minor assessment
A minor assessment includes one or both of the following: a brief history and examination of the affected part or region or related to a mental or emotional disorder…
$26.80
A004 General re-assessment
A general re-assessment is a comprehensive assessment service that includes all the elements of a general assessment (A003), with the exception that the patient's history does not…
$39.35
A007 Intermediate assessment or well baby care
An intermediate assessment is a primary care general practice service that requires a more extensive examination than a minor assessment.
$44.55
A003 General assessment(this code)
A general assessment is a service, rendered at a place other than in a patient’s home that requires a full history (the elements of which must include a history of the presenting…
$95.60

Consultations

A006 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$47.10
A005 Consultation
A consultation is an assessment rendered following a written request from a referring: physician 2.
$95.60

A general assessment is a service, rendered at a place other than in a patient’s home that requires a full history (the elements of which must include a history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems), and, except for breast, genital or rectal examination where not medically indicated or refused, an examination of all body parts and systems, and may include a detailed examination of one or more parts or systems.

Full history (the elements of which must include a history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems).

Examination of all body parts and systems (except for breast, genital or rectal examination where not medically indicated or refused), and may include a detailed examination of one or more parts or systems.

Usage limits

Limited to one per patient per physician per 12 month period. May be increased to two if the second assessment is for a clearly different/unrelated diagnosis or is a hospital admission assessment at least 90 days later.

A004General re-assessment A007Intermediate assessment or well baby care A001Minor assessment

A003 is not eligible for payment for an assessment provided in the patient’s home.

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