A715 – Consultation
OHIP General Listings Code — Critical Care Medicine (11) · Schedule of Benefits
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 specialist in Critical Care Medicine because of the complexity, seriousness, or obscurity of the case. It includes the services necessary to enable the consultant to prepare a written report to the referring provider.
When to Use
- Bill A715 when a Critical Care Medicine specialist provides an assessment and written report following a referral from a physician, NP, or dental surgeon for a complex or serious case outside of an inpatient hospital setting.
- Use A715 for an initial assessment in the Emergency Department requested by the ED physician for a critically ill patient requiring specialized input.
- A715 is appropriate when a specialist provides a consultation and detailed report for a patient in a long-term care facility, as requested by their attending physician.
Common Pitfalls
- Billing A715 when the patient is already an inpatient in a hospital; C715 is the correct code for inpatient consultations.
- Failing to obtain and retain a written request from the referring provider, which is a mandatory requirement for A715.
- Not providing a written report to the referring provider, as this service is integral to the A715 consultation fee.
Billing Tips
- Ensure the written request for A715 clearly identifies the patient, referring provider (with OHIP billing number), consultant, and the specific reason for consultation.
- A715 is eligible for the C101 Intensive or Coronary Care Unit Premium if the consultation occurs in an ICU/CCU, provided other restrictions are met.
Effective: June 1, 2025
Consultations and Visits
Critical Care Medicine (11)
Professional Fee
Consultation
Written request from a referring physician, NP, or dental surgeon must be in the medical record.
Written report must be provided to the referring physician/NP.
Must include a general, specific, or medical specific assessment.
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.
A715A is designated for Video Only virtual care.
Eligible for special visit premiums if criteria are met.
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