What is OHIP billing code A245?

A245 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A245 pay?

The current OHIP fee for A245 is $92.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A245 to OHIP?

A245 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A245 claims against the Schedule of Benefits rules before submission.

What codes are related to A245?

Codes related to A245 in the Schedule of Benefits include A935, A246, A243, A244, C245, W345, W346.

All codes

A245

A245 – Consultation

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

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Levels of this visit

The A24x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A244 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…
$30.45
A243 Specific assessment
Specific assessment and medical specific assessment are services rendered by specialists, in a place other than a patient’s home, and require a full history of the presenting…
$44.75

Consultations

A246 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…
$53.65
A245 Consultation(this code)
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental…
$92.70

A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure in a hospital) who requests the opinion of a physician competent to give advice in the field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or representative.

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) must be provided 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.

The written request sets out the information relevant to the referral and specifies the service(s) required.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician (except for repeat consultations or specific hospital/ED scenarios). Consultations for clearly defined unrelated diagnoses are limited to one service every 12 months.

A935Special surgical consultation A246Repeat consultation A243Specific assessment A244Partial assessment C245Consultation (In-patient)W345Consultation (Non-Emergency Long-Term Care In-Patient Services)W346Repeat consultation (Non-Emergency Long-Term Care In-Patient Services)

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

Preoperative consultations for low-risk elective surgical procedures (e.g., cataract surgery, colonoscopy, cystoscopy, carpal tunnel surgery, or arthroscopic surgery) are only eligible for payment where the medical record demonstrates the consultation is medically necessary.

If the consultant requests a referral after the service has been provided, a consultation is not payable; the appropriate visit fee should be claimed instead.

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