What is OHIP billing code W055?

W055 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W055 pay?

The current OHIP fee for W055 is $152.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W055 to OHIP?

W055 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W055 claims against the Schedule of Benefits rules before submission.

What codes are related to W055?

Codes related to W055 in the Schedule of Benefits include W050, W400, W405, W056, W402, W404, W407.

All codes

W055

W055 – Consultation

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

Ask a question

Levels of this visit

The W05x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

W054 General re-assessment of patient in nursing home
General re-assessment of a patient in a nursing home, as per the Nursing Homes Act.
$20.60

Consultations

W056 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…
$94.75
W055 Consultation(this code)
A consultation, as defined in GP16 of the Schedule of Benefits, for a patient in a non-emergency long-term care institution.
$152.80
W050 Special community medicine consultation
A special community medicine consultation rendered to a patient in a long-term care institution.
$176.10

A consultation, as defined in of the Schedule of Benefits, for a patient in a non-emergency long-term care institution. This service requires a written request from a referring physician, nurse practitioner, or dental surgeon for the consultant's opinion on a complex, serious, or obscure case. The service includes all elements of an assessment, a review of all relevant data, and the preparation of a written report (including findings, opinions, and recommendations) to the referring practitioner. This code is specifically for services rendered in settings such as chronic care hospitals, convalescent hospitals, nursing homes, or homes for the aged.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

W050 W400 W405 W056 W402 W404 W407

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds.

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in