What is OHIP billing code A113?

A113 is "Complex neurological assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A113 pay?

The current OHIP fee for A113 is $120.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A113 to OHIP?

A113 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A113 claims against the Schedule of Benefits rules before submission.

What codes are related to A113?

Codes related to A113 in the Schedule of Benefits include C113, W113.

All codes

A113

A113 – Complex neurological assessment

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

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Levels of this visit

The A11x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A118 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…
$44.75
A110 Periodic oculo-visual assessment
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$48.90
A112 Periodic oculo-visual assessment - aged 65 years and above
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$48.90
A114 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist that requires a full, relevant history and physical examination of one or more systems.
$72.00
A111 Complex medical specific re-assessment
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition and includes all the…
$83.40
A113 Complex neurological assessment(this code)
An assessment for the ongoing management of complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and…
$120.00

Consultations

A116 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…
$122.00

An assessment for the ongoing management of complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and where the visit requires a minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention.

Minimum of 20 minutes in direct contact with the patient.

Must include the elements of a medical specific re-assessment (full, relevant history and physical examination of one or more systems).

The start and stop times must be recorded in the patient’s permanent medical record.

The patient must have an established diagnosis of a chronic complex neurological disease, documented in the medical record.

Usage limits

Limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

C113Complex neurological assessment - Hospital W113Complex neurological assessment - Nursing Home/Chronic Care

If the service does not include the elements of a medical specific re-assessment, the amount payable will be adjusted to a lesser assessment fee.

If start and stop times are not recorded, the amount payable will be adjusted to a lesser paying fee.

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