What is OHIP billing code A130?

A130 is "Comprehensive internal medicine consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A130 pay?

The current OHIP fee for A130 is $342.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A130 to OHIP?

A130 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A130 claims against the Schedule of Benefits rules before submission.

What codes are related to A130?

Codes related to A130 in the Schedule of Benefits include A135, A435, A136.

All codes

A130

A130 – Comprehensive internal medicine consultation

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

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Levels of this visit

The A13x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A138 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
A134 Medical specific re-assessment
A service rendered by a specialist in Internal Medicine requiring a full, relevant history and physical examination of one or more systems.
$72.00
A131 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.
$83.40
A133 Medical specific assessment
A service rendered by a specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and detailed examination of the affected part(s)…
$95.95

Consultations

A136 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…
$123.10
A135 Consultation
A consultation is an assessment rendered following a written request from a referring: physician 2.
$192.85
A130 Comprehensive internal medicine consultation(this code)
A consultation rendered by a specialist in internal medicine who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of…
$342.25

A consultation rendered by a specialist in internal medicine who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.

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.

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.

A written report (including findings, opinions, and recommendations) must be provided to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.

Minimum of 75 minutes of direct contact with the patient is required.

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

Usage limits

Consultations for the same patient by the same physician for the same diagnosis are limited to one service per two consecutive 12-month periods (with specific exceptions for hospital/ED settings).

A135Internal Medicine Consultation (Standard)A435Internal Medicine Limited Consultation A136Internal Medicine Repeat Consultation

Calculation of time excludes non-patient-facing time such as reviewing charts, imaging, or documentation.

Eligible for age-based fee premiums () for patients under 16 years of age.

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