What is OHIP billing code A478?

A478 is "Partial assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A478 pay?

The current OHIP fee for A478 is $45.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A478 to OHIP?

A478 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A478 claims against the Schedule of Benefits rules before submission.

What codes are related to A478?

Codes related to A478 in the Schedule of Benefits include A570, A473, A474, E078.

All codes

A478

A478 – Partial 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(this code)
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
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 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 record. In the context of Respiratory Disease, it is intended for the evaluation and/or management of uncomplicated respiratory disorders, such as routine follow-up of uncomplicated chronic obstructive pulmonary disease (e.g., emphysema, chronic bronchitis).

History of the presenting complaint.

Necessary physical examination.

Advice to the patient.

Appropriate medical record.

Usage limits

Generally not limited in frequency; serves as the 'lesser assessment fee' for other respiratory assessments that exceed their respective limits.

A570Complex respiratory assessment A473Medical specific assessment A474Medical specific re-assessment E078Chronic disease assessment premium

A478 is the designated fallback code for Respiratory Disease assessments (A473, A474, A471, A570) when frequency limits are exceeded.

Not intended for complex respiratory failure or conditions requiring intensive management (which may qualify for A570).

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