What is OHIP billing code A235?

A235 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A235 pay?

The current OHIP fee for A235 is $86.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A235 to OHIP?

A235 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A235 claims against the Schedule of Benefits rules before submission.

What codes are related to A235?

Codes related to A235 in the Schedule of Benefits include A231, A930, A233, A234.

All codes

A235

A235 – Consultation

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

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Levels of this visit

The A23x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A230 Orthoptic assessment
Orthoptic assessment must include quantitative measurement of all cardinal positions of gaze (straight ahead, left, right, up, down, tilt right and tilt left), sensory testing for…
$26.20
A234 Partial assessment
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate…
$31.95
A237 Periodic oculo-visual assessment - aged 19 years and below
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$59.35
A239 Periodic oculo-visual assessment - aged 65 years and above
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$59.35
A233 Specific assessment
A specific assessment is a service rendered by a specialist, in a place other than a patient’s home, that requires a full history of the presenting complaint and detailed…
$60.50

Consultations

A236 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…
$48.00
A235 Consultation(this code)
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental…
$86.25
A231 Neuro-ophthalmology consultation
A consultation rendered by an ophthalmologist with fellowship training in neuro-ophthalmology for a patient with a neuro-ophthalmological disorder, requiring specific documented…
$155.45

A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental procedures). The consultant physician, due to the complexity, seriousness, or obscurity of the case, provides an opinion and recommendations. The service includes the necessary assessment elements and a written report back to the referrer.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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 consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

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 (unless it is a repeat consultation or rendered in a hospital/ED setting after 12 months). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A231Neuro-ophthalmology consultation A930Uveitis and ocular inflammatory diseases consultation A233Specific assessment A234Partial assessment

Preoperative consultations for cataract surgery are only eligible for payment where the medical record demonstrates the consultation is medically necessary (noted as very uncommon). (p.)

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