What is OHIP billing code A135?

A135 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A135 pay?

The current OHIP fee for A135 is $192.85, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A135 to OHIP?

A135 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A135 claims against the Schedule of Benefits rules before submission.

What codes are related to A135?

Codes related to A135 in the Schedule of Benefits include A130, A435, A136, C135, W235.

All codes

A135

A135 – 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(this code)
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 consultation is an assessment rendered following a written request from a referring: 1. physician 2. nurse practitioner or 3. dental surgeon in connection with an insured dental procedure rendered in a hospital, who, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician”) competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient’s representative. A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) 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. Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

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. In such cases, the written request may be contained on the common medical record.

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 sent to the referring provider.

Consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.

Usage limits

One per two consecutive 12-month periods for the same diagnosis by the same physician (with specific exceptions for hospital/ED settings); one every 12 months for a clearly defined unrelated diagnosis.

A130Comprehensive internal medicine consultation A435Limited consultation A136Repeat consultation C135In-patient consultation W235Long-term care consultation

If the physician is in the hospital but not on duty in the ED, A135 is used for seeing patients in the Emergency or OPD.

Eligible for the 17% Hospitalist Premium if the physician meets qualifying criteria.

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