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A185 – Consultation

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

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Levels of this visit

The A18x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A188 Partial assessment

    Partial assessment rendered by a specialist in Neurology (18).

    $39.40

  • A184 Medical specific re-assessment

    Medical specific re-assessment rendered by a specialist in Neurology (18).

    $64.95

  • A181 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…

    $75.20

  • A183 Medical specific assessment

    Medical specific assessment rendered by a specialist in Neurology (18).

    $82.40

Consultations

  • A186 Repeat consultation

    Repeat consultation rendered by a specialist in Neurology (18).

    $125.50

  • A185 Consultation(this code)

    A consultation is an assessment rendered by a neurologist following a written request from a referring physician, nurse practitioner, or dental surgeon.

    $225.55

  • A180 Special neurology consultation

    Special neurology consultation is a consultation in which the physician provides all the elements of a consultation (A185) and spends a minimum of 75 minutes in direct contact…

    $342.25
A consultation is an assessment rendered by a neurologist following a written request from a referring physician, nurse practitioner, or dental surgeon. The neurologist provides an opinion and advice due to the complexity, seriousness, or obscurity of the patient's condition. The service includes a general, specific, or medical specific assessment and the preparation of a written report containing findings, opinions, and recommendations.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
Written request identifying the consultant, referrer, and patient, and specifying the service required.
Performance of a general, specific, or medical specific assessment, including a review of all relevant data.
A written report must be sent to the referring physician or nurse practitioner.
The request and report must be maintained in the patient's medical record.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
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.
A written report (including findings, opinions, and recommendations) 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.
Usage limits
Limited to one service per two consecutive 12-month periods for the same diagnosis by the same consultant, with exceptions for hospital inpatients or Emergency Department visits between 12 and 24 months after the first consultation.
A180A682A385A186A113A183A184A181A188A384K181

If consultation requirements (request/report) are not met, the fee is reduced to a lesser assessment fee.

Age-based premiums apply for patients under 16 years of age (10% to 30% increase).

A185 is the base consultation code for Neurology; time-based consultations (A180, A682) are built upon its requirements.

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