What is OHIP billing code A511?

A511 is "Complex physiatry assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A511 pay?

The current OHIP fee for A511 is $114.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A511 to OHIP?

A511 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A511 claims against the Schedule of Benefits rules before submission.

What codes are related to A511?

Codes related to A511 in the Schedule of Benefits include A510, A310, A318, C511, W511.

All codes

A511

A511 – Complex physiatry assessment

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

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Levels of this visit

The A51x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A510 Complex neuromuscular assessment
An assessment for the ongoing management of specific diseases of the neuromuscular system where the complexity of the condition requires the continuing management by a physical…
$104.85
A511 Complex physiatry assessment(this code)
This service is an assessment in relation to traumatic brain injury, stroke (hemorrhagic and ischemic), or spinal cord injury where the complexity of the condition requires the…
$114.80

Consultations

A515 Limited consultation
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation.
$106.60

This service is an assessment in relation to traumatic brain injury, stroke (hemorrhagic and ischemic), or spinal cord injury where the complexity of the condition requires the ongoing management by a physical medicine and rehabilitation specialist.

Must include the elements of a medical specific re-assessment (full, relevant history and physical examination of one or more systems).

If the elements of a medical specific re-assessment are not met, the fee will be adjusted to a lesser assessment fee.

Usage limits

Limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

A510Complex neuromuscular assessment A310Medical specific re-assessment A318Partial assessment C511Complex physiatry assessment (Hospital In-patient)W511Complex physiatry assessment (Long-Term Care)

A511 is intended for ongoing management, not initial evaluation (though the initial evaluation restriction is explicitly stated for A510, the definition of A511 emphasizes 'ongoing management').

Special Visit Premiums (SVPs) may be eligible if the visit is non-elective and meets the criteria in -.

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