What is OHIP billing code A595?

A595 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A595 pay?

The current OHIP fee for A595 is $124.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A595 to OHIP?

A595 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A595 claims against the Schedule of Benefits rules before submission.

What codes are related to A595?

Codes related to A595 in the Schedule of Benefits include A485, A590, A486, A480.

All codes

A595

A595 – Limited consultation

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

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Levels of this visit

The A59x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

A595 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.
$124.50
A590 Comprehensive rheumatology consultation
A consultation rendered by a specialist in rheumatology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of direct…
$342.25

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

A written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure in a hospital) must be kept in the consulting physician’s medical record.

The consultant must be competent to give advice in the field due to the complexity, seriousness, or obscurity of the case.

A written report (including findings, opinions, and recommendations) must be sent to the referring provider.

The consultant is required to perform a general, specific, or medical specific assessment, including a review of all relevant data.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician (with specific exceptions for hospital inpatients or emergency department visits between 12 and 24 months). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A485Consultation A590Comprehensive rheumatology consultation A486Repeat consultation A480Complex rheumatology assessment

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

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

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