All codes
A565
A565 – Limited consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
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. Otherwise, a limited consultation has the same requirements as a full consultation.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
Requires a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).
The consultant must prepare a written report (findings, opinions, recommendations) to the referring provider.
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 kept in the medical record (or common medical record in hospitals/clinics).
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.
Usage limits
Consultations (including limited) for the same diagnosis are limited to one service per two consecutive 12-month periods by the same physician.
If consultation requirements (written request/report) are not met, the fee will be reduced to a lesser assessment fee.
Neurodevelopmental consultations for less complex conditions (e.g., ADHD) are payable at a lesser fee (A565).
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