What is OHIP billing code A286?

A286 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A286 pay?

The current OHIP fee for A286 is $108.95, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill A286 to OHIP?

A286 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A286 claims against the Schedule of Benefits rules before submission.

What codes are related to A286?

Codes related to A286 in the Schedule of Benefits include A285, A586, A283, A284, A580, A585.

All codes

A286

A286 – Limited 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(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.
$108.95
A285 Consultation
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 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 of findings and recommendations.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A consultation is an assessment rendered following a written request from a referring: 1. physician 2. nurse practitioner or 3. dental surgeon in connection with an insured dental procedure rendered in a hospital, who, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician”) competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient’s representative.

A consultation includes the services necessary to enable the consultant to prepare 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. Except where otherwise specified, 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

Consultations for the same diagnosis are limited to one service per two consecutive 12-month periods. Consultations for a clearly defined unrelated diagnosis are limited to one service every 12 months.

A285Consultation A586Repeat consultation A283Medical specific assessment A284Partial assessment A580Comprehensive laboratory medicine consultation A585Diagnostic consultation

Under 'Family Practice & Practice in General', a limited consultation is the service rendered by a non-specialist where only services constituting a specific assessment are rendered.

Preoperative consultations for low-risk elective procedures (e.g., cataract surgery, colonoscopy) are only eligible if the medical record demonstrates medical necessity.

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