What is OHIP billing code A161?

A161 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A161 pay?

The current OHIP fee for A161 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A161 to OHIP?

A161 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A161 claims against the Schedule of Benefits rules before submission.

What codes are related to A161?

Codes related to A161 in the Schedule of Benefits include A163, A164, C161, E060.

All codes

A161

A161 – Complex medical specific re-assessment

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

Ask a question

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(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 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
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 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 requirements of a medical specific re-assessment (a full, relevant history and physical examination of one or more systems).

Requires a full, relevant history and physical examination of one or more systems.

The physician must report findings, opinions, or recommendations in writing to the patient’s primary care physician.

Failure to provide the written report will result in the fee being adjusted to a lesser assessment fee.

Usage limits

Limited to 4 per patient per physician per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

A163Medical specific assessment A164Medical specific re-assessment C161Complex medical specific re-assessment (In-patient)E060Post Renal Transplant Assessment Premium

The 'Complex' designation is based on the complexity, obscurity, or seriousness of the patient's condition.

The fee for A161 is $83.40 (Specialist fee).

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in