All codes
A865
A865 – Limited consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation. Otherwise, a limited consultation has the same requirements as a full consultation.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner, or dental surgeon.
A copy of the signed written request must be kept in the consultant's medical record.
The request must identify the consultant, the referrer (with billing number), and the patient (with health number).
The consultant must 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 for the same patient by the same physician for the same diagnosis. Consultations for a clearly defined unrelated diagnosis are limited to one service every 12 months.
If the requirements for a consultation are not met (e.g., no written request or report), the fee will be adjusted to a lesser assessment fee.
A865 is specifically listed under Nephrology (16) but follows the general preamble definitions for limited consultations.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.