What is OHIP billing code A635?

A635 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A635 pay?

The current OHIP fee for A635 is $188.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A635 to OHIP?

A635 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A635 claims against the Schedule of Benefits rules before submission.

What codes are related to A635?

Codes related to A635 in the Schedule of Benefits include A835, A735, A636, A633, A638, A631, A835, A735.

All codes

A635

A635 – Consultation

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

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Levels of this visit

The A63x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A631 Minor assessment
A minor assessment is the service rendered when a nuclear medicine specialist evaluates a patient on a non-emergent basis resulting in the cancellation or deferral of a planned…
$26.80
A632 Minor assessment
A minor assessment is the service rendered when a nuclear medicine specialist evaluates a patient on a non-emergent basis on the advisability of performing a diagnostic nuclear…
$26.80
A638 Partial assessment
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate…
$48.00
A633 Specific assessment
A specialist assessment requiring a full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis…
$72.00

Consultations

A636 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…
$84.00
A635 Consultation(this code)
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon in connection with an insured dental…
$188.40

A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon in connection with an insured dental procedure rendered in a hospital, who requests the opinion of a physician competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or representative. It includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring provider. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable. Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon is required.

The request must identify the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and the patient by name and health number, and set out the information relevant to the referral and specify the service(s) required.

A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.

The consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

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.

Usage limits

Limited to one service per patient per two consecutive 12-month periods for the same diagnosis by the same physician (except for specific hospital/ED circumstances). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A835Comprehensive nuclear medicine consultation A735Diagnostic consultation A636Repeat consultation A633Specific assessment A638Partial assessment A631Minor assessment A835 A735 A636 A633 A638 A631 C635 C835 C735 C636 A632

If a physician is already in the hospital and assesses one of their own patients, it constitutes a subsequent visit, not a consultation.

Consultations requested by a Medical Trainee are adjusted to the amount payable for a general or specific assessment.

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