What is OHIP billing code A725?

A725 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A725 pay?

The current OHIP fee for A725 is $192.85, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A725 to OHIP?

A725 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A725 claims against the Schedule of Benefits rules before submission.

What codes are related to A725?

Codes related to A725 in the Schedule of Benefits include A720, A925, A726, A723, A724, A721, A728.

All codes

A725

A725 – Consultation

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

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Levels of this visit

The A72x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A728 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
A724 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in Occupational Medicine (72) that requires a full, relevant history and physical examination of one or more…
$72.00
A721 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.
$83.40
A723 Medical specific assessment
Specific assessment and medical specific assessment are services rendered by specialists, in a place other than a patient’s home, and require a full history of the presenting…
$95.95

Consultations

A726 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…
$123.10
A725 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…
$192.85
A720 Comprehensive occupational medicine consultation
This service is a consultation rendered by a specialist in occupational medicine who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in…
$342.25

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 in a hospital). The consultant physician, competent in occupational medicine, provides an opinion due to the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or their representative. The service includes the necessary assessment and a written report (findings, opinions, and recommendations) to the referring provider.

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. 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 request would ordinarily also include appropriate clinical information, such as the reason for the referral for consultation, present and past history, physical findings and relevant test results and reports.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis by the same physician (unless it is a repeat consultation or meets specific hospital/ED exceptions). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

A720Comprehensive occupational medicine consultation A925Limited consultation A726Repeat consultation A723Medical specific assessment A724Medical specific re-assessment A721Complex medical specific re-assessment A728Partial assessment

Preoperative consultations for low-risk elective procedures (e.g., cataract surgery, colonoscopy) are only eligible if the medical record demonstrates the consultation is medically necessary.

Consultations requested by a Medical Trainee are adjusted to a lesser assessment fee.

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