What is OHIP billing code A255?

A255 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A255 pay?

The current OHIP fee for A255 is $110.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A255 to OHIP?

A255 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A255 claims against the Schedule of Benefits rules before submission.

What codes are related to A255?

Codes related to A255 in the Schedule of Benefits include A155, A150, A156, C255.

All codes

A255

A255 – Limited consultation

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

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Levels of this visit

The A25x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A250 Retinopathy of prematurity assessment
Retinopathy of Prematurity (ROP) assessment is the service rendered by an ophthalmologist for initial assessment or follow-up assessment(s) of a patient with ROP who is either: 9…
$125.80
A251 Special ophthalmologic assessment
A complete ophthalmologic assessment, rendered by an ophthalmologist, to a person with a psychological problem, developmental delay, learning disability, or significant physical…
$125.80
A254 Follow-up vision rehabilitation assessment
A follow-up vision rehabilitation assessment by an ophthalmologist of a patient with either low visual acuity, visual field defect, or significant oculomotor dysfunction.
$125.80
A252 Initial vision rehabilitation assessment
Initial vision rehabilitation assessment by an ophthalmologist of a patient with either low visual acuity, visual field defect, or significant oculomotor dysfunction, requiring a…
$251.65

Consultations

A255 Limited consultation(this code)
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation.
$110.15

A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation. Otherwise, a limited consultation has the same requirements as a full consultation, including a written request from a referring physician, nurse practitioner, or dental surgeon, and a written report to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request identifying the consultant, referring provider, and patient must be kept in the medical record.

The consultant must provide a written report (findings, opinions, and recommendations) to the referring provider.

The service must meet the definition of a consultation but be less demanding/time-consuming than a full consultation (A155).

Usage limits

Limited to one service per patient per two consecutive 12-month periods for the same diagnosis by the same physician, except in specific circumstances (e.g., hospital inpatient or emergency department settings for the second consultation).

A155Consultation (Endocrinology & Metabolism)A150Comprehensive endocrinology consultation A156Repeat consultation C255Limited consultation (Hospital Inpatient)

If the consultation requirements (e.g., written request, report) are not met, the fee will be adjusted to a lesser assessment fee.

A255 is the limited version of the full consultation (A155) for Endocrinology.

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