What is OHIP billing code A623?

A623 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A623 pay?

The current OHIP fee for A623 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A623 to OHIP?

A623 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A623 claims against the Schedule of Benefits rules before submission.

What codes are related to A623?

Codes related to A623 in the Schedule of Benefits include A625, A525, A626, A624, A621, A628, C623.

All codes

A623

A623 – Medical specific assessment

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

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Levels of this visit

The A62x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A628 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
A624 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in Clinical Immunology (62) that requires a full, relevant history and physical examination of one or more…
$72.00
A621 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
A623 Medical specific assessment(this code)
A medical specific assessment is a service rendered by a specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed…
$95.95

Consultations

A626 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$105.25
A625 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental…
$160.30

A medical specific assessment is a service rendered by a specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.

Full history of the presenting complaint.

Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.

Service must be rendered in a place other than the patient's home.

Usage limits

Limited to 1 per patient per physician per 12-month period. This limit is increased to 2 per 12-month period if: 1) The patient presents with a clearly different and unrelated diagnosis; or 2) At least 90 days have elapsed and the second assessment is a hospital admission assessment.

A625Consultation A525Limited consultation A626Repeat consultation A624Medical specific re-assessment A621Complex medical specific re-assessment A628Partial assessment C623Medical specific assessment (In-patient)

Physicians in hospital but not on duty in the Emergency Department seeing patients in the Emergency or OPD should use General Listings (A623).

Hospital in-patient version of this service is billed as C623.

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