What is OHIP billing code A193?

A193 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A193 pay?

The current OHIP fee for A193 is $98.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A193 to OHIP?

A193 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A193 claims against the Schedule of Benefits rules before submission.

What codes are related to A193?

Codes related to A193 in the Schedule of Benefits include A194, C193, K630.

All codes

A193

A193 – Specific assessment

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

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Levels of this visit

The A19x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A194 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…
$47.05
A193 Specific assessment(this code)
A specific assessment is a service rendered by a specialist in Psychiatry, in a place other than a patient’s home, requiring a full history of the presenting complaint and a…
$98.70

Consultations

A196 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…
$120.30
A195 Psychiatric consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental…
$254.30
A190 Special psychiatric consultation
Special psychiatric consultation is a consultation in which the physician provides all the elements of a consultation (A195) and spends a minimum of 75 minutes in direct contact…
$342.25

A specific assessment is a service rendered by a specialist in Psychiatry, in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

Full history of the presenting complaint.

Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

Appropriate record of the service.

Usage limits

Limited to one per patient per physician per 12-month period. The limit is increased to two per 12-month period if: 1) The patient presents with a clearly different and unrelated diagnosis; or 2) At least 90 days have elapsed and the second assessment is a hospital admission assessment.

A194Partial assessment (Psychiatry)C193Specific assessment (Hospital)K630Psychiatric consultation extension

A193 is an assessment, not a consultation; therefore, it does not require a formal referral from another physician.

A193 is not eligible for the Psychiatric Consultation Extension (K630).

A193 is not eligible for the Chronic Disease Assessment Premium (specialty 19 is not listed).

A193 is not eligible for Age-based fee premiums (these apply to consultations or specific assessments in Ophthalmology only).

A193 is not eligible for the First Visit After Hospital Discharge Premium (E080).

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