What is OHIP billing code A611?

A611 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A611 pay?

The current OHIP fee for A611 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A611 to OHIP?

A611 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A611 claims against the Schedule of Benefits rules before submission.

What codes are related to A611?

Codes related to A611 in the Schedule of Benefits include A613, A614, A618, C611, E078.

All codes

A611

A611 – Complex medical specific re-assessment

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

Ask a question

Levels of this visit

The A61x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A618 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…
$44.75
A614 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in Haematology (61) that requires a full, relevant history and physical examination of one or more systems.
$72.00
A611 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 and includes all the…
$83.40
A613 Medical specific assessment
A service rendered by a specialist in Haematology, in a place other than a patient’s home, requiring a full history of the presenting complaint and detailed examination of the…
$95.95

Consultations

A616 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…
$118.05
A615 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon who requests the opinion of a haematology…
$192.90

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

The physician must report his/her findings, opinions, or recommendations in writing to the patient’s primary care physician or the amount payable for the service will be adjusted to a lesser assessment fee.

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

Usage limits

Limited to 4 per patient per physician per 12 month period (including combinations with A613).

A613Medical specific assessment A614Medical specific re-assessment A618Partial assessment C611Complex medical specific re-assessment (Hospital In-patient)E078Chronic disease assessment premium

For services not listed under Haematology, refer to the Internal Medicine section.

Special visit premiums (-) may apply if the service is the first patient seen during a non-routine visit.

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in