What is OHIP billing code A093?

A093 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A093 pay?

The current OHIP fee for A093 is $55.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A093 to OHIP?

A093 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A093 claims against the Schedule of Benefits rules before submission.

What codes are related to A093?

Codes related to A093 in the Schedule of Benefits include A095, A096, A094, C093.

All codes

A093

A093 – Specific assessment

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

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Levels of this visit

The A09x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A094 Partial assessment
A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate…
$30.35
A093 Specific assessment(this code)
A service rendered by a specialist in Cardiac Surgery (09) in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination…
$55.70

Consultations

A096 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…
$75.20
A095 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for insured dental procedures in hospital).
$113.15

A service rendered by a specialist in Cardiac Surgery (09) in a place other than a patient’s home, requiring 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, and/or exclude disease, and/or assess function.

Full history of the presenting complaint.

Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, or assess function.

Usage limits

Limited to one per patient per physician per 12-month period. The limit is increased to two per 12-month period if the patient presents a second time with a complaint for which the diagnosis is clearly different and unrelated to the diagnosis made at the time of the first specific assessment.

A095Consultation A096Repeat consultation A094Partial assessment C093Hospital in-patient specific assessment

If usage limits are exceeded, the amount payable will be adjusted to a lesser assessment fee.

Special visit premiums (Travel and First Person Seen) may be applicable for non-elective visits to an office or outpatient department if criteria are met (see -).

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