What is OHIP billing code A625?

A625 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A625 pay?

The current OHIP fee for A625 is $160.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A625 to OHIP?

A625 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A625 claims against the Schedule of Benefits rules before submission.

What codes are related to A625?

Codes related to A625 in the Schedule of Benefits include A525, A626, C625, A623, E078, A624, A621, A628.

All codes

A625

A625 – Consultation

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
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(this code)
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 consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental procedures). The consultant physician, due to the complexity, seriousness, or obscurity of the case, provides an opinion and recommendations. The service includes a general, specific, or medical specific assessment, a review of all relevant data, and the preparation of a written report to the referrer.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.

The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

A written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.

Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

Usage limits

Limited to one service per two consecutive 12-month periods (i.e., once every 24 months) for the same diagnosis by the same physician. A second consultation for the same diagnosis is only eligible if rendered to a hospital inpatient or in an Emergency Department between 12 and 24 months after the first. Consultations for a clearly defined unrelated diagnosis are limited to one per 12-month period.

A525Limited consultation A626Repeat consultation C625Hospital In-patient Consultation A623Medical specific assessment E078Chronic disease assessment premium (applicable to assessments, not A625)A624Medical specific re-assessment A621Complex medical specific re-assessment A628Partial assessment C525Limited consultation C626Repeat consultation C623Medical specific assessment C624Medical specific re-assessment C621Complex medical specific re-assessment

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

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