What is OHIP billing code A225?

A225 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A225 pay?

The current OHIP fee for A225 is $190.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A225 to OHIP?

A225 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A225 claims against the Schedule of Benefits rules before submission.

What codes are related to A225?

Codes related to A225 in the Schedule of Benefits include A220, A223, A325, A226, A221, A800.

All codes

A225

A225 – 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(this code)
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
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

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 dental surgeon. The service includes the necessary elements to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring provider. The consultant is required to perform a general, specific, or medical specific assessment, including a review of all relevant data.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request signed by the referring provider must be kept in the consultant'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 must identify 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 consultant must provide a written report of findings, opinions, and recommendations to the referring provider.

If the referral is from a nurse practitioner, the report must also be sent to the patient's primary care provider, if applicable.

Usage limits

Limited to one service per patient per physician per two consecutive 12-month periods for the same diagnosis. If the diagnosis is clearly unrelated, it is limited to one service every 12 months. Exceptions apply for hospital inpatients or Emergency Department patients where a second consultation may be billed between 12 and 24 months after the first.

A220Special genetic consultation (minimum 75 minutes)A223Extended special genetic consultation (minimum 90 minutes)A325Limited consultation A226Repeat consultation A221Genetic minor assessment A800Midwife or Aboriginal Midwife-requested genetic assessment

A225 is the base consultation code for Genetics. For time-based consultations, see A220 (75 min) or A223 (90 min).

Midwife-requested genetic assessments use codes A800, A801, or A802.

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