What is OHIP billing code A005?

A005 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A005 pay?

The current OHIP fee for A005 is $95.60, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A005 to OHIP?

A005 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A005 claims against the Schedule of Benefits rules before submission.

What codes are related to A005?

Codes related to A005 in the Schedule of Benefits include A911, A912, A945, A101A, A102A, A911, A912, H055.

All codes

A005

A005 – Consultation

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
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(this code)
A consultation is an assessment rendered following a written request from a referring: physician 2.
$95.60

A consultation is an assessment rendered following a written request from a referring: 1. physician 2. nurse practitioner or 3. dental surgeon in connection with an insured dental procedure rendered in a hospital, who, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician”) competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient’s representative. A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable. Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

Referral required

A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.

The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician. A second consultation for the same diagnosis is only eligible if rendered for a hospital inpatient or ED patient between 12 and 24 months after the first. Consultations for a clearly defined unrelated diagnosis are limited to one every 12 months.

A911Special family and general practice consultation (50 min)A912Comprehensive family and general practice consultation (75 min)A945Special palliative care consultation A101ALimited Virtual Care Service (Video)A102ALimited Virtual Care Service (Telephone)A911Special family and general practice consultation A912Comprehensive family and general practice consultation H055Specialist in emergency medicine (FRCP)H065All other physicians (ED)A935Special surgical consultation C935Special surgical consultation (in-patient)

Preoperative consultations for low-risk elective procedures (cataract surgery, colonoscopy, cystoscopy, carpal tunnel surgery, or arthroscopic surgery) are only eligible if the medical record demonstrates the consultation is medically necessary.

If the consultation is requested by a Medical Trainee, the fee is adjusted to an assessment fee.

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