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A615 – Consultation

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

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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

    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(this code)

    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 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 specialist because of the complexity, seriousness, or obscurity of the case. The service includes the necessary elements to prepare a written report to the referrer.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
Written request from a referring physician, NP, or dental surgeon.
Written report (findings, opinions, recommendations) sent to the referrer.
Must include a general, specific or medical specific assessment, including a review of all relevant data (implying history and physical examination).
Start and stop times are not required for A615 (unlike comprehensive or time-based consultations).
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 (unless common medical records are maintained in hospital, LTC, or multi-specialty clinic).
The request identifies the consultant by name and/or specialty, the referring physician, nurse practitioner or dental surgeon by name and billing number, and 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
One service per two consecutive 12-month periods for the same diagnosis; one per 12 months for a clearly defined unrelated diagnosis.
A655Limited ConsultationA616Repeat ConsultationC615In-patient Consultation

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

Physicians in hospital but not on duty in the ED should use A615 for patients seen in the Emergency or OPD.

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