What is OHIP billing code A064?

A064 is "Partial assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A064 pay?

The current OHIP fee for A064 is $25.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A064 to OHIP?

A064 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A064 claims against the Schedule of Benefits rules before submission.

What codes are related to A064?

Codes related to A064 in the Schedule of Benefits include A065, A063, A066, C064.

All codes

A064

A064 – Partial assessment

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

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Levels of this visit

The A06x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A064 Partial assessment(this code)
Partial assessment rendered by an Orthopaedic Surgeon (Specialty 06).
$25.95
A063 Specific assessment
A specific assessment is a service rendered by a specialist (Orthopaedic Surgery) in a place other than a patient’s home.
$45.55

Consultations

A066 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…
$55.35
A065 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).
$89.80

Partial assessment rendered by an Orthopaedic Surgeon (Specialty 06).

A history of the presenting complaint.

The necessary physical examination.

Advice to the patient.

An appropriate record of the service.

Usage limits

No specific frequency limit is defined for partial assessments in the General Preamble, unlike general or specific assessments.

A065Consultation A063Specific assessment A066Repeat consultation C064Specific re-assessment (In-patient)

A064 is a 'General Listing' code for Orthopaedic Surgery.

Not eligible for the Chronic Disease Assessment Premium (E078) as Orthopaedic Surgery is not an eligible specialty.

Not eligible for Age-Based Fee Premiums as it is an assessment, not a consultation or surgical procedure.

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