What is OHIP billing code A054?

A054 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A054 pay?

The current OHIP fee for A054 is $64.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A054 to OHIP?

A054 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A054 claims against the Schedule of Benefits rules before submission.

What codes are related to A054?

Codes related to A054 in the Schedule of Benefits include A053, A051, A058, C054.

All codes

A054

A054 – Medical specific re-assessment

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

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Levels of this visit

The A05x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A058 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…
$39.95
A054 Medical specific re-assessment(this code)
A medical specific re-assessment is a service rendered by a specialist in community medicine that requires a full, relevant history and physical examination of one or more systems.
$64.30
A051 Complex medical specific re-assessment
A service rendered by a specialist in Community Medicine (05) requiring a full, relevant history and physical examination of one or more systems.
$74.45
A053 Medical specific assessment
A service rendered by a specialist in Community Medicine in a place other than a patient’s home, requiring a full history of the presenting complaint and detailed examination of…
$83.85

Consultations

A056 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…
$94.75
A055 Consultation
A consultation rendered by a specialist in community medicine following a written request from a referring physician, nurse practitioner, or dental surgeon.
$152.80
A050 Special community medicine consultation
A consultation rendered by a specialist in community medicine who provides all the appropriate elements of a consultation and spends a minimum of 50 minutes in direct contact with…
$176.10

A medical specific re-assessment is a service rendered by a specialist in community medicine that requires a full, relevant history and physical examination of one or more systems.

Requires a full, relevant history and physical examination of one or more systems.

If rendered as a virtual care service (A054A), it must meet the requirements for comprehensive virtual care (video or telephone).

Usage limits

Limited to two per patient per physician per consecutive 12-month period, except for specific re-assessments rendered for hospital admissions. Services in excess of this limit are adjusted to a lesser assessment fee.

A053Medical specific assessment A051Complex medical specific re-assessment A058Partial assessment C054Medical specific re-assessment (Hospital In-Patient)

Admission assessments are deemed to be a medical specific re-assessment if the patient was assessed by the same physician prior to admission for the same illness.

A054 is specifically listed under the Community Medicine (05) specialty section.

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