What is OHIP billing code A111?

A111 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A111 pay?

The current OHIP fee for A111 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A111 to OHIP?

A111 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A111 claims against the Schedule of Benefits rules before submission.

What codes are related to A111?

Codes related to A111 in the Schedule of Benefits include C111, A114, A713, A118.

All codes

A111

A111 – Complex medical specific re-assessment

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

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Levels of this visit

The A11x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A118 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
A110 Periodic oculo-visual assessment
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$48.90
A112 Periodic oculo-visual assessment - aged 65 years and above
A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia…
$48.90
A114 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist that requires a full, relevant history and physical examination of one or more systems.
$72.00
A111 Complex medical specific re-assessment(this code)
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
A113 Complex neurological assessment
An assessment for the ongoing management of complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and…
$120.00

Consultations

A116 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…
$122.00

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 requirements of a medical specific re-assessment.

Requires a full, relevant history and physical examination of one or more systems.

The physician must report his/her findings, opinions, or recommendations in writing to the patient’s primary care physician or the amount payable for the service will be adjusted to a lesser assessment fee.

Usage limits

Limited to 4 per patient per physician per 12-month period. This limit applies to A111 alone or in any combination with medical specific assessments (e.g., A713). Services in excess of this limit are adjusted to a lesser assessment fee.

C111Complex medical specific re-assessment (in-patient)A114Medical specific re-assessment A713Medical specific assessment A118Partial assessment

A111 is the specific complex re-assessment code for Critical Care Medicine (11).

Eligible for Special Visit Premiums (e.g., Travel and First Person Seen) when the criteria for a special visit are met (non-elective, travel required, etc.).

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