What is OHIP billing code A601?

A601 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A601 pay?

The current OHIP fee for A601 is $84.10, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A601 to OHIP?

A601 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A601 claims against the Schedule of Benefits rules before submission.

What codes are related to A601?

Codes related to A601 in the Schedule of Benefits include A603, A604, C601, E088.

All codes

A601

A601 – Complex medical specific re-assessment

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

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Levels of this visit

The A60x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A608 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…
$49.80
A604 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist and requires a full, relevant history and physical examination of one or more systems.
$72.65
A601 Complex medical specific re-assessment(this code)
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.
$84.10
A603 Medical specific assessment
A medical specific assessment is a specialist service requiring a full history of the presenting complaint and a detailed examination of the affected systems to make a diagnosis…
$96.70

Consultations

A606 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another…
$105.25
A605 Consultation
A consultation rendered by a specialist in cardiology following a written request from a referring physician, nurse practitioner, or dental surgeon.
$188.45
A600 Comprehensive cardiology consultation
This service is a consultation rendered by a specialist in cardiology who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in direct…
$342.25

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. It includes all the requirements of a medical specific re-assessment (a full, relevant history and physical examination of one or more systems).

Requires a full, relevant history and physical examination of one or more systems.

The physician must report findings, opinions, or recommendations in writing to the patient’s primary care physician.

The service must be necessitated by the complexity, obscurity, or seriousness of the patient's condition.

Usage limits

Limited to 4 per patient per physician per 12 month period (alone or in combination with A603). Claims in excess of this limit are adjusted to a lesser assessment fee.

A603Medical specific assessment A604Medical specific re-assessment C601Complex medical specific re-assessment (Hospital)E088Congestive heart failure premium

If the written report to the primary care physician is not provided, the fee will be adjusted to a lesser assessment fee.

For Cardiology (60), the fees for office-based (A601) and hospital-based (C601) assessments are identical ($84.10).

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