What is OHIP billing code A385?

A385 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A385 pay?

The current OHIP fee for A385 is $125.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A385 to OHIP?

A385 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A385 claims against the Schedule of Benefits rules before submission.

What codes are related to A385?

Codes related to A385 in the Schedule of Benefits include A185, A186, A180, A682, A113.

All codes

A385

A385 – Limited consultation

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

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Levels of this visit

The A38x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

A385 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.
$125.50
A384 Consultation and Management for Acute Cerebral Vascular Syndrome
A Consultation and Management for ACVS is a service in which the physician provides all the elements of a consultation (A185) to a patient referred for suspected ACVS and, if…
$275.95

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, it 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 to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request signed by the referring provider must be kept in the consultant's medical record.

The request must identify the consultant, the referring provider (name and billing number), and the patient (name and health number).

The consultant must prepare a written report (findings, opinions, and recommendations) and send it to the referring provider.

If the referral is from a nurse practitioner, the report must also be sent to the patient's primary care provider if applicable.

Usage limits

Limited to one service per patient per physician for the same diagnosis every two consecutive 12-month periods. If a second consultation is required for the same diagnosis within 12-24 months, it is only eligible if the patient is a hospital inpatient or in the Emergency Department.

A185Neurology Consultation A186Neurology Repeat Consultation A180Special Neurology Consultation (minimum 75 minutes)A682Extended Special Neurology Consultation (minimum 90 minutes)A113Complex Neurological Assessment

A limited consultation is intended for cases that are less demanding and require substantially less time than a full consultation (A185).

If a physician has already been paid for a consultation for the same diagnosis and makes a request for a referral for ongoing management, subsequent services are not payable as consultations.

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