What is OHIP billing code A483?

A483 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A483 pay?

The current OHIP fee for A483 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A483 to OHIP?

A483 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A483 claims against the Schedule of Benefits rules before submission.

All codes

A483

A483 – Medical specific assessment

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

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Levels of this visit

The A48x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A488 Partial assessment
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…
$44.75
A484 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in rheumatology that requires a full, relevant history and physical examination of one or more systems.
$72.00
A481 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.
$83.40
A483 Medical specific assessment(this code)
A medical specific assessment is a service rendered by a specialist in Rheumatology in a place other than a patient's home.
$95.95
A480 Complex rheumatology assessment
A complex rheumatology assessment is an assessment for the ongoing management of specific complex disorders of the musculoskeletal system where the complexity of the condition…
$113.85

Consultations

A486 Repeat consultation
Repeat consultation rendered by a specialist in Rheumatology.
$125.10
A485 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon who requests the opinion of a rheumatologist…
$202.40

A medical specific assessment is a service rendered by a specialist in Rheumatology in a place other than a patient's home. According to the Schedule of Benefits, this service 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, and/or exclude disease, and/or assess function. In addition to the common elements, all services which are described as assessments, or as including assessments (e.g. consultations), include the following specific elements: • A. A direct physical encounter with the patient including taking a patient history and performing a physical examination. • B. Other inquiry (including taking a patient history), carried out to arrive at an opinion as to the nature of the patient's condition, (whether such inquiry takes place before, during or after the encounter during which the physical examination takes place) and/or follow-up care. • C. Performing any procedure(s) during the same encounter as the physical examination, unless the procedure(s) is(are) separately listed in the Schedule and an amount is payable for the procedure in conjunction with an assessment. • D. Making arrangements for any related assessments, procedures or therapy, and/or interpreting results. • E. Making arrangements for follow-up care. • F. Discussion with, and providing advice and information, including prescribing therapy to the patient or the patient's representative, whether by telephone or otherwise, on matters related to the service and results. • G. When medically indicated, monitoring the condition of the patient and intervening, until the next insured service is provided. • H. Providing premises, equipment, supplies, and personnel for the specific elements of the service except for any aspect(s) that is (are) performed in a hospital or nursing home.

As with all insured services, the medical record must establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.

Documentation must include 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, and/or exclude disease, and/or assess function.

Limit

Maximum undefined per 12_months (per patient per physician). Limited to one per patient per physician per 12 month period unless either of the following circumstances are met in which case the limit is increased to two per patient per physician per 12 month period: 1. the patient presents a second time with a complaint for which a clearly different diagnosis is made, unrelated to the diagnosis made at the time of the first specific assessment in that 12 month period; or 2. in the case of a medical specific assessment, at least 90 days have elapsed since the date of the last specific assessment and the second assessment is a hospital admission assessment. The amount payable for specific or medical specific assessments in excess of this limit will be adjusted to a lesser assessment fee.

Limit

Maximum undefined per 12_months (per patient per physician). Any combination of medical specific assessments and complex medical specific re-assessments are limited to 4 per patient per physician per 12 month period. The amount payable for these services in excess of this limit will be adjusted to a lesser assessment fee.

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