What is OHIP billing code A275?

A275 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A275 pay?

The current OHIP fee for A275 is $119.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A275 to OHIP?

A275 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A275 claims against the Schedule of Benefits rules before submission.

What codes are related to A275?

Codes related to A275 in the Schedule of Benefits include A465, A460, A270, C275.

All codes

A275

A275 – Limited consultation

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

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Levels of this visit

The A27x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A270 Complex infectious disease assessment
This service is an assessment for the ongoing management of any of the following infectious diseases where the complexity of the condition requires the continuing management by an…
$95.05

Consultations

A275 Limited consultation(this code)
A consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation.
$119.30

A consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation. It requires a written request from a referring physician/NP and a written report back to the referrer.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Written request from a referring physician, nurse practitioner, or dental surgeon.

Written report back to the referring provider including findings, opinions, and recommendations.

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

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

Usage limits

One service per patient per physician per two consecutive 12-month periods for the same diagnosis (subject to specific exceptions for hospital/ED settings).

A465Consultation - Infectious Disease A460Comprehensive infectious disease consultation A270Complex infectious disease assessment C275Limited consultation - Infectious Disease (In-patient)

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

Services in excess of frequency limits are adjusted to a lesser assessment fee.

The referring physician, nurse practitioner or dental surgeon must determine if multiple requests by a patient or the patient’s representative to different physicians in the same specialty for the same condition are medically necessary. Services that are not medically necessary are uninsured.

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