What is OHIP billing code A285?

A285 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A285 pay?

The current OHIP fee for A285 is $163.00, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill A285 to OHIP?

A285 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A285 claims against the Schedule of Benefits rules before submission.

What codes are related to A285?

Codes related to A285 in the Schedule of Benefits include A286, A585, A586, A283, A284.

All codes

A285

A285 – Consultation

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

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Levels of this visit

The A28x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A284 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…
$38.85
A283 Medical specific assessment
A service rendered by a specialist in Laboratory Medicine requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or…
$82.50

Consultations

A286 Limited consultation
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.
$108.95
A285 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…
$163.00

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, competent in the field due to the complexity, seriousness, or obscurity of the case, provides an opinion and recommendations. The service includes a general, specific, or medical specific assessment and requires a written report to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon must be kept in the medical record (except in hospital, LTC, or multi-specialty clinic with common records).

The request must identify the consultant by name and/or specialty, the referring provider by name and billing number, and the patient by name and health number.

The written request must set out information relevant to the referral and specify services required.

The consultant must provide a written report (findings, opinions, and recommendations) to the referring provider (and primary care provider if referral by NP).

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

Usage limits

Limited to one service per patient per two consecutive 12-month periods for the same diagnosis by the same physician. A second consultation for the same diagnosis is eligible if rendered to a hospital in-patient or in an Emergency Department more than 12 months but less than 24 months after the first.

A286Limited consultation A585Diagnostic consultation A586Repeat consultation A283Medical specific assessment A284Partial assessment

Consultations for the same patient by the same consultant with a clearly defined unrelated diagnosis are limited to one service every 12 months.

For emergency calls and other special visits to in-patients, use General Listings and Premiums ( to ).

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