What is OHIP billing code A155?

A155 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A155 pay?

The current OHIP fee for A155 is $172.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A155 to OHIP?

A155 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A155 claims against the Schedule of Benefits rules before submission.

What codes are related to A155?

Codes related to A155 in the Schedule of Benefits include A150, A255, A156, K045.

All codes

A155

A155 – Consultation

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
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(this code)
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 consultation rendered by a specialist in Endocrinology & Metabolism following a written request from a referring physician, nurse practitioner, or dental surgeon, including a written report to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Written request from a referring physician, NP, or dental surgeon must be kept in the consulting physician’s medical record (unless common records in 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.

Written report including findings, opinions, and recommendations sent 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).

Must include a general, specific or medical specific assessment, including a review of all relevant data.

Usage limits

One per 24 months for the same diagnosis; one per 12 months for a clearly defined unrelated diagnosis.

A150Comprehensive endocrinology consultation A255Limited consultation A156Repeat consultation K045Diabetes management by a specialist

Eligible for special visit premiums if criteria are met ().

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