What is OHIP billing code A473?

A473 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A473 pay?

The current OHIP fee for A473 is $102.60, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A473 to OHIP?

A473 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A473 claims against the Schedule of Benefits rules before submission.

What codes are related to A473?

Codes related to A473 in the Schedule of Benefits include A475, A470, A474, A471, A478, A570, C473.

All codes

A473

A473 – Medical specific assessment

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

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Levels of this visit

The A47x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A478 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…
$45.25
A474 Medical specific re-assessment
A medical specific re-assessment rendered by a specialist in Respiratory Disease (47), requiring a full, relevant history and physical examination of one or more systems.
$75.30
A471 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.
$89.40
A473 Medical specific assessment(this code)
A medical specific assessment is a service rendered by a specialist in respiratory disease (specialty 47) in a place other than a patient’s home.
$102.60

Consultations

A476 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…
$119.35
A475 Consultation
Consultation Respiratory Disease
$192.30
A470 Comprehensive respiratory disease consultation
A consultation rendered by a specialist in respiratory disease who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in direct contact…
$342.25

A medical specific assessment is a service rendered by a specialist in respiratory disease (specialty 47) in a place other than a patient’s home. It requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

Full history of the presenting complaint.

Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.

Usage limits

Limited to one per patient per physician per 12-month period. A second assessment is allowed within the same 12-month period if: 1. The patient presents with a clearly different and unrelated diagnosis; or 2. At least 90 days have elapsed since the last specific assessment and the second assessment is for a hospital admission.

A475Consultation A470Comprehensive respiratory disease consultation A474Medical specific re-assessment A471Complex medical specific re-assessment A478Partial assessment A570Complex respiratory assessment C473Medical specific assessment (In-patient)

If the 12-month limit is exceeded, the fee is adjusted to a lesser assessment fee (e.g., partial assessment).

For services not listed in the Respiratory Disease section, refer to the Internal Medicine section.

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