What is OHIP billing code A475?

A475 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A475 pay?

The current OHIP fee for A475 is $192.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A475 to OHIP?

A475 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A475 claims against the Schedule of Benefits rules before submission.

What codes are related to A475?

Codes related to A475 in the Schedule of Benefits include A470, A575, A476, A473, A474, A471, A478, A570.

All codes

A475

A475 – Consultation

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
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(this code)
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

Consultation - Respiratory Disease

A written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental procedures) is required.

The consultant must be competent to give advice in the field of Respiratory Disease due to the complexity, seriousness, or obscurity of the case.

A written report including findings, opinions, and recommendations must be provided to the referring practitioner.

The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.

A copy of the signed written request must be maintained in the consultant's medical record.

Usage limits

Limited to one service per patient per physician per two consecutive 12-month periods for the same diagnosis, unless the patient is a hospital inpatient or in the Emergency Department (where a second consultation may be eligible between 12 and 24 months).

A470Comprehensive respiratory disease consultation A575Limited consultation A476Repeat consultation A473Medical specific assessment A474Medical specific re-assessment A471Complex medical specific re-assessment A478Partial assessment A570Complex respiratory assessment

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

If the requirements for a consultation are not met (e.g., no written request or report), the fee will be adjusted to a lesser assessment fee.

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