What is OHIP billing code A220?

A220 is "Special genetic consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A220 pay?

The current OHIP fee for A220 is $342.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A220 to OHIP?

A220 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A220 claims against the Schedule of Benefits rules before submission.

What codes are related to A220?

Codes related to A220 in the Schedule of Benefits include A225, A223, A221, A226, A325, C220, A801, W220.

All codes

A220

A220 – Special genetic consultation

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

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Levels of this visit

The A22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A221 Genetic minor assessment
A minor assessment provided by a geneticist or a specialist with FCCMG designation, involving a brief history and examination or brief advice/information regarding health…
$38.05

Consultations

A226 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…
$119.40
A225 Consultation
A consultation rendered by a specialist in Genetics (22) or a specialist with FCCMG designation, following a written request from a referring physician, nurse practitioner, or…
$190.50
A220 Special genetic consultation(this code)
Special genetic consultation is a consultation in which the physician provides all the elements of a consultation (A225) and spends a minimum of 75 minutes in direct contact with…
$342.25
A223 Extended special genetic consultation
Extended special genetic consultation is a consultation in which the physician provides all the elements of a consultation (A225) and spends a minimum of 90 minutes in direct…
$442.40

Special genetic consultation is a consultation in which the physician provides all the elements of a consultation (A225) and spends a minimum of 75 minutes in direct contact with the patient with or without family, exclusive of time spent rendering any other separately billable intervention to the patient.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon is required.

A written report (including findings, opinions, and recommendations) must be sent to the referring provider.

The physician must spend a minimum of 75 minutes in direct contact with the patient (with or without family).

Start and stop times of the service must be recorded in the patient's permanent 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.

Usage limits

Limited to one service per patient, per physician, per 24-month period for the same diagnosis (as per general consultation limits for time-based consultations).

A225Consultation A223Extended special genetic consultation (minimum 90 minutes)A221Genetic minor assessment A226Repeat consultation A325Limited consultation C220Special genetic consultation (Hospital Inpatient)A801Comprehensive midwife or aboriginal midwife-requested genetic assessment W220Special genetic consultation (Long-Term Care In-Patient)

Calculation of time excludes non-patient-facing time such as time spent reviewing charts, imaging, or documentation.

Calculation of time excludes time devoted to any other service or procedure for which an amount is payable in addition to the consultation.

If the requirements for a special genetic consultation (e.g., time or documentation) are not met, the fee may be reduced to a lesser assessment fee.

In the event these requirements are not met, the amount payable for a consultation will be reduced to a lesser assessment fee.

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