What is OHIP billing code A025?

A025 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A025 pay?

The current OHIP fee for A025 is $77.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A025 to OHIP?

A025 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A025 claims against the Schedule of Benefits rules before submission.

What codes are related to A025?

Codes related to A025 in the Schedule of Benefits include A021, A026, A023, A024.

All codes

A025

A025 – Consultation

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

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Levels of this visit

The A02x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A024 Partial assessment
A limited service constituting a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record.
$23.50
A023 Specific assessment
A specific assessment is a service rendered by a specialist in Dermatology (02) in a place other than the patient's home.
$46.15
A020 Complex dermatology assessment
An assessment for the ongoing management of complex dermatological conditions where the complexity of the condition requires continuing management by a dermatology specialist.
$60.00

Consultations

A026 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…
$47.75
A025 Consultation(this code)
An assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon, including a general, specific or medical specific assessment…
$77.50
A027 Consultation in association with special visit
Consultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patient.
$158.15
A021 Advanced Dermatology Consultation
A consultation for the investigation, diagnosis, and management of complex diseases of the integumentary system where the complexity of the condition requires the medical…
$164.90

An assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon, including a general, specific or medical specific assessment, review of all relevant data, and preparation of a written report to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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.

Usage limits

Generally limited to one consultation per patient per 12-month period for the same diagnosis, unless a new and unrelated condition necessitates a further consultation.

A021Advanced Dermatology Consultation A026Repeat consultation A023Specific assessment A024Partial assessment

Age-based premiums for patients under 16 years of age () apply to this code.

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