What is OHIP billing code A468?

A468 is "Partial assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A468 pay?

The current OHIP fee for A468 is $62.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A468 to OHIP?

A468 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A468 claims against the Schedule of Benefits rules before submission.

What codes are related to A468?

Codes related to A468 in the Schedule of Benefits include A465, A460, A270, A463, E078, A275, A466, A464.

All codes

A468

A468 – Partial assessment

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

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Levels of this visit

The A46x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A468 Partial assessment(this code)
A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate…
$62.15
A464 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist that requires a full, relevant history and physical examination of one or more systems.
$82.10
A461 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.
$95.05
A463 Medical specific assessment
A service rendered by an infectious disease specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination of…
$107.00

Consultations

A466 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$124.00
A465 Consultation
A consultation rendered by an infectious disease specialist following a written request from a referring physician, nurse practitioner, or dental surgeon.
$205.90
A460 Comprehensive infectious disease consultation
A comprehensive infectious disease consultation requiring a minimum of 75 minutes in direct contact with the patient, satisfying all elements of a consultation as defined in the…
$342.25

A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate record.

History of the presenting complaint.

Necessary physical examination.

Advice to the patient.

Appropriate medical record.

Usage limits

No specific frequency limit for A468, but complex assessments (A270) in this section are limited to 6 per 12 months.

A465Consultation A460Comprehensive infectious disease consultation A270Complex infectious disease assessment A463Medical specific assessment E078Chronic disease assessment premium A275Limited consultation A466Repeat consultation A464Medical specific re-assessment A461Complex medical specific re-assessment A468Partial assessment

The start and stop times should be recorded in the patient's permanent medical record as per the section requirements on page A125.

Eligible for Special Visit Premiums if the visit is non-elective and meets -78 criteria.

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