What is OHIP billing code A131?

A131 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A131 pay?

The current OHIP fee for A131 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A131 to OHIP?

A131 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A131 claims against the Schedule of Benefits rules before submission.

What codes are related to A131?

Codes related to A131 in the Schedule of Benefits include A133.

All codes

A131

A131 – Complex medical specific re-assessment

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(this code)
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
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 complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient's condition. It includes all the requirements of a medical specific re-assessment, which requires a full, relevant history and physical examination of one or more systems. The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician or the amount payable for the service will be adjusted to a lesser assessment fee.

The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician.

Usage limits

OR([4, "12_months", "per_patient_per_physician", "Complex medical specific re-assessments (A131) are limited to 4 per patient per physician per 12 month period."], [4, "12_months", "per_patient_per_physician", "The total number of services for medical specific assessments (A133) and complex medical specific re-assessments (A131) combined is limited to 4 per patient per physician per 12 month period."])

A133

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