What is OHIP billing code A013?

A013 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A013 pay?

The current OHIP fee for A013 is $64.65, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill A013 to OHIP?

A013 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A013 claims against the Schedule of Benefits rules before submission.

What codes are related to A013?

Codes related to A013 in the Schedule of Benefits include A014, C013, A015, A210, A816.

All codes

A013

A013 – Specific assessment

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

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Levels of this visit

The A01x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A014 Partial assessment
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate…
$31.45
A013 Specific assessment(this code)
A specialist assessment rendered by an anaesthesiologist (specialty 01) in a place other than the patient's home.
$64.65

Consultations

A016 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another…
$52.15
A015 Consultation
A consultation rendered by an anaesthesia (01) specialist following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital dental…
$109.70

A specialist assessment rendered by an anaesthesiologist (specialty 01) in a place other than the patient's home. It requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

Full history of the presenting complaint.

Detailed examination of the affected part(s), region(s), or system(s).

Findings and recommendations must be documented in the patient's permanent medical record.

Usage limits

Limited to one per patient per physician per 12-month period. A second assessment is allowed within 12 months if for a clearly different diagnosis or if it is a hospital admission assessment at least 90 days after the first.

A014Partial assessment C013Specific assessment (In-patient)A015Consultation A210Special anaesthetic consultation A816Midwife or Aboriginal Midwife-Requested Anaesthesia Assessment (MAMRAA)

The routine pre-anaesthetic evaluation does not constitute a consultation or assessment regardless of where or when it is performed.

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