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A575 – Limited consultation

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

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Levels of this visit

The A57x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A570 Complex respiratory assessment

    This service is an assessment for the ongoing management of the following conditions of the respiratory system where the complexity of the condition requires the continuing…

    $108.95

Consultations

  • A575 Limited consultation(this code)

    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.

    $119.35
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 (written request, opinion on a complex/serious/obscure case, and a written report).
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A written request from a referring physician, nurse practitioner, or dental surgeon is required.
The consultant must provide a written report (including findings, opinions, and recommendations) to the referring practitioner.
The consultant is required to perform a general, specific, or medical specific assessment, including a review of all relevant data.
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. In such cases, the written request may be contained on the common medical record.
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
Limited to one service per patient, per physician, per two consecutive 12-month periods for the same diagnosis (with specific exceptions for hospital inpatients or Emergency Department visits between 12 and 24 months after the first consultation).
A475Consultation - respiratory diseaseA470Comprehensive respiratory disease consultationA476Repeat consultation - respiratory diseaseA570Complex respiratory assessment

A limited consultation is intended for cases that are less demanding than a full consultation (A475).

If the requirements for a consultation (e.g., written request, report) are not met, the fee will be adjusted to a lesser assessment fee.

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