What is OHIP billing code A315?

A315 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A315 pay?

The current OHIP fee for A315 is $220.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A315 to OHIP?

A315 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A315 claims against the Schedule of Benefits rules before submission.

What codes are related to A315?

Codes related to A315 in the Schedule of Benefits include A425, A515, A316, C315.

All codes

A315

A315 – Consultation

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
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(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…
$220.80

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 Physical Medicine & Rehabilitation, provides an opinion or advice due to the complexity, seriousness, or obscurity of the case, or at the request of the patient/representative. The service includes the necessary assessment and the preparation of a written report back to the referrer.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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.

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.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician (except for hospital inpatients or ED patients where a second consultation may be eligible between 12 and 24 months). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A425Comprehensive physical medicine and rehabilitation consultation A515Limited consultation A316Repeat consultation C315Consultation - Hospital In-patient

A315 is the standard consultation code for PM&R.

A425 is available for comprehensive consultations requiring a minimum of 75 minutes of direct contact.

A515 is used for limited consultations that are less demanding than a full consultation.

A316 is used for repeat consultations.

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