What is OHIP billing code W155?

W155 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W155 pay?

The current OHIP fee for W155 is $172.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W155 to OHIP?

W155 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W155 claims against the Schedule of Benefits rules before submission.

What codes are related to W155?

Codes related to W155 in the Schedule of Benefits include W765, W150, W255, W156, A155, C155.

All codes

W155

W155 – Consultation

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

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Levels of this visit

The W15x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

W154 General re-assessment of patient in nursing home
A general re-assessment of a patient in a nursing home as defined by the Nursing Homes Act.
$20.60

Consultations

W156 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…
$110.15
W155 Consultation(this code)
A consultation provided by a specialist in Endocrinology & Metabolism (15) for a patient in a non-emergency long-term care (LTC) setting.
$172.95
W150 Comprehensive endocrinology consultation
A comprehensive endocrinology consultation provided by a specialist in Endocrinology & Metabolism for a patient in a non-emergency, long-term care setting.
$342.25

A consultation provided by a specialist in Endocrinology & Metabolism (15) for a patient in a non-emergency long-term care (LTC) setting. This includes patients in Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals, but excludes patients in designated palliative care beds, as specified on page . As defined on page , a consultation is an assessment initiated by a written request from a referring physician, nurse practitioner, or dental surgeon. The request is made because the patient's case is complex, serious, or obscure, or a second opinion is required. The service requires the consultant to prepare a written report with findings, opinions, and recommendations for the referring practitioner. For emergency calls or other special visits to these patients, General Listings (A prefix codes) and applicable special visit premiums must be used instead.

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. In a long-term care institution where common medical records are maintained, the written request may be contained on the common medical record.

The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.

The written request must set out the information relevant to the referral and specifies the service(s) required.

A written report, including findings, opinions, and recommendations, must be prepared and sent to the referring practitioner.

Usage limits

OR([1, "24_months", "per_patient_per_physician", "For the same diagnosis, limited to one service per two consecutive 12-month periods. A second consultation is payable if rendered to a hospital inpatient or ED patient more than 12 but less than 24 months after the first."], [1, "12_months", "per_patient_per_physician", "For a clearly defined unrelated diagnosis."])

W765 W150 W255 W156 A155 C155

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