What is OHIP billing code A603?

A603 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A603 pay?

The current OHIP fee for A603 is $96.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A603 to OHIP?

A603 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A603 claims against the Schedule of Benefits rules before submission.

What codes are related to A603?

Codes related to A603 in the Schedule of Benefits include C603, A604, A601.

All codes

A603

A603 – Medical specific 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
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(this code)
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 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, exclude disease, or assess function.

Full history of presenting complaint

Detailed examination of affected part(s), region(s), or system(s)

Direct physical encounter (unless virtual suffix A is used)

Usage limits

Limited to one per patient per physician per 12 month period (increased to two if diagnosis is clearly different or if 90 days have elapsed and it is a hospital admission).

C603Medical specific assessment (In-patient)A604Medical specific re-assessment A601Complex medical specific re-assessment

If rendered to a hospital in-patient, use code C603.

Cardiology (60) is not eligible for the Chronic Disease Assessment Premium (E078) under current rules.

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