What is OHIP billing code A164?

A164 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A164 pay?

The current OHIP fee for A164 is $72.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A164 to OHIP?

A164 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A164 claims against the Schedule of Benefits rules before submission.

All codes

A164

A164 – Medical specific re-assessment

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(this code)
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
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 medical specific re-assessment rendered by a specialist in Nephrology. As per page , a medical specific re-assessment is a service rendered by a specialist and requires a full, relevant history and physical examination of one or more systems. An admission assessment is deemed to be a medical specific re-assessment for those patients who have been assessed by a physician and subsequently admitted to the hospital for the same illness by the same physician.

If the E060 Post Renal Transplant Assessment Premium is claimed, the purpose of the assessment (post-transplant care) and the patient's status (within the first three years of transplant) must be documented.

If claiming the Chronic Disease Assessment Premium, the patient's medical record must document the established diagnosis of a chronic disease from the approved list on page .

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