What is OHIP billing code A153?

A153 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A153 pay?

The current OHIP fee for A153 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A153 to OHIP?

A153 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A153 claims against the Schedule of Benefits rules before submission.

What codes are related to A153?

Codes related to A153 in the Schedule of Benefits include A154, A151, A158, C153, A150, A760.

All codes

A153

A153 – Medical specific assessment

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

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Levels of this visit

The A15x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A158 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
A154 Medical specific re-assessment
A service rendered by a specialist in Endocrinology & Metabolism requiring a full, relevant history and physical examination of one or more systems.
$72.00
A151 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
A153 Medical specific assessment(this code)
A medical specific assessment is a service rendered by a specialist in Endocrinology & Metabolism (15) in a place other than a patient’s home.
$95.95

Consultations

A156 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…
$110.15
A155 Consultation
A consultation rendered by a specialist in Endocrinology & Metabolism following a written request from a referring physician, nurse practitioner, or dental surgeon, including a…
$172.95
A150 Comprehensive endocrinology consultation
A consultation rendered by a specialist in endocrinology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes in direct…
$342.25

A medical specific assessment is a service rendered by a specialist in Endocrinology & Metabolism (15) in a place other than a patient’s home. It requires 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. This may be increased to two per 12 month period if the patient presents with a clearly different and unrelated diagnosis, or if at least 90 days have elapsed and the second assessment is a hospital admission assessment.

A154Medical specific re-assessment A151Complex medical specific re-assessment A158Partial assessment C153Medical specific assessment (In-patient)A150Comprehensive endocrinology consultation A760Complex endocrine neoplastic disease assessment

The amount payable for assessments in excess of the 12-month limits will be adjusted to a lesser assessment fee (typically a partial assessment).

A153 is the office/out-patient version; C153 is the corresponding in-patient version.

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