What is OHIP billing code A311?

A311 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A311 pay?

The current OHIP fee for A311 is $82.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A311 to OHIP?

A311 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A311 claims against the Schedule of Benefits rules before submission.

What codes are related to A311?

Codes related to A311 in the Schedule of Benefits include A310, A313, C311, E078.

All codes

A311

A311 – Complex medical specific re-assessment

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

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Levels of this visit

The A31x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A318 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…
$44.45
A310 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist (specifically Physical Medicine & Rehabilitation) that requires a full, relevant history and physical…
$75.90
A311 Complex medical specific re-assessment(this code)
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition and includes all the…
$82.75
A313 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in a place other than a patient's home.
$86.40

Consultations

A316 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…
$106.60
A315 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…
$220.80

A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition and includes all the requirements of a medical specific re-assessment (a full, relevant history and physical examination of one or more systems).

The physician must report findings, opinions, or recommendations in writing to the patient’s primary care physician.

Usage limits

Limited to 4 per patient per physician per 12 month period. This limit is shared with A313 (Medical specific assessment).

A310Medical specific re-assessment A313Medical specific assessment C311Complex medical specific re-assessment (In-patient)E078Chronic disease assessment premium

A311 is the out-patient/office code; C311 is the equivalent code for hospital in-patients.

The fee for A311 is $82.75.

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