SnapBill MD
All codes

A485 – Consultation

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

Ask a question

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

    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(this code)

    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 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 because of the complexity, seriousness, or obscurity of the case. It includes the services necessary to prepare a written report to the referring provider.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
Written request from a referring physician, nurse practitioner or dental surgeon.
Written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
Full history and assessment of the patient.
Usage limits
One per patient per physician per two consecutive 12-month periods for the same diagnosis (subject to exceptions).
A480Complex rheumatology assessmentA590Comprehensive rheumatology consultationA486Repeat consultationK481Rheumatoid arthritis management by a specialistA480A590A595A486A483A484A481A488

A485 is not intended for the evaluation of uncomplicated rheumatologic disorders (e.g., osteoarthritis, bursitis, neck/back pain) if billed as a complex assessment.

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

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started FreeAlready have an account? Sign in

We use cookies to measure site usage and improve your experience. You can manage your preferences at any time.