What is OHIP billing code A160?

A160 is "Comprehensive nephrology consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A160 pay?

The current OHIP fee for A160 is $342.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A160 to OHIP?

A160 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A160 claims against the Schedule of Benefits rules before submission.

What codes are related to A160?

Codes related to A160 in the Schedule of Benefits include A165, A166, A865, E060, A163, A164, A161, A168.

All codes

A160

A160 – Comprehensive nephrology consultation

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

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Levels of this visit

The A16x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A168 Partial assessment
A partial assessment is a limited medical service that includes a history of the patient's presenting complaint, the necessary physical examination, advice to the patient, and the…
$44.75
A164 Medical specific re-assessment
A medical specific re-assessment rendered by a specialist in Nephrology.
$72.00
A161 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 and includes all the…
$83.40
A163 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in Nephrology (16) in a place other than a patient’s home.
$95.95

Consultations

A166 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…
$116.75
A165 Consultation
A consultation rendered by a specialist in nephrology following a written request from a referring physician, nurse practitioner, or dental surgeon.
$180.75
A160 Comprehensive nephrology consultation(this code)
A consultation rendered by a specialist in nephrology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of direct…
$342.25

A consultation rendered by a specialist in nephrology 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 required

Must satisfy all elements of a consultation as defined in (written request from referring physician/NP/dental surgeon, written report back to referrer).

Minimum of 75 minutes of direct contact with the patient.

Start and stop times must be recorded in the patient's permanent medical record.

The calculation of the 75-minute minimum excludes time devoted to any other service or procedure for which an amount is payable in addition to the consultation.

The calculation of time excludes non-patient-facing time (e.g., reviewing charts, imaging, or documentation).

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician. Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A165 A166 A865 E060 A163 A164 A161 A168

Age-based fee premiums apply: 30% (<30 days), 25% (30 days to <1 year), 20% (1 year to <2 years), 15% (2 years to <5 years), 10% (5 years to <16 years).

A160A is designated as a 'Video Only' virtual care service.

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