What is OHIP billing code W085?

W085 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W085 pay?

The current OHIP fee for W085 is $106.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W085 to OHIP?

W085 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W085 claims against the Schedule of Benefits rules before submission.

What codes are related to W085?

Codes related to W085 in the Schedule of Benefits include W086.

All codes

W085

W085 – Consultation

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

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Levels of this visit

The W08x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W086 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…
$62.80
W085 Consultation(this code)
This service is for a non-emergency consultation by a Plastic Surgeon for a patient in a Long-Term Care Institution, which includes Chronic Care Hospitals, Convalescent Hospitals…
$106.25

This service is for a non-emergency consultation by a Plastic Surgeon for a patient in a Long-Term Care Institution, which includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals (other than designated palliative care beds). As per the definition on page , a consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon. It requires a comprehensive assessment of the patient's condition, a review of all relevant data, and the preparation of a written report with findings, opinions, and recommendations sent back to the referring practitioner.

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, 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.

W086

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

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