What is OHIP billing code A203?

A203 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A203 pay?

The current OHIP fee for A203 is $62.65, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A203 to OHIP?

A203 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A203 claims against the Schedule of Benefits rules before submission.

What codes are related to A203?

Codes related to A203 in the Schedule of Benefits include A204, A205, A206.

All codes

A203

A203 – Specific assessment

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

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Levels of this visit

The A20x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A204 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…
$40.50
A203 Specific assessment(this code)
A service rendered by a specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and detailed examination of the affected part(s)…
$62.65

Consultations

A206 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$71.45
A205 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon.
$134.25

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

Usage limits

Limited to one per patient per physician per 12 month period. The limit is increased to two if: 1) the patient presents a second time with a clearly different diagnosis unrelated to the first, or 2) it is a medical specific assessment and 90 days have elapsed and the second is a hospital admission assessment. Excess services are adjusted to a lesser assessment fee.

A204Partial assessment A205Consultation A206Repeat consultation

Specific assessments are services rendered by specialists in a place other than a patient's home.

The amount payable for assessments in excess of the 12-month limit will be adjusted to a lesser assessment fee.

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