What is OHIP billing code W160?

W160 is "Comprehensive nephrology consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W160 pay?

The current OHIP fee for W160 is $342.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W160 to OHIP?

W160 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W160 claims against the Schedule of Benefits rules before submission.

What codes are related to W160?

Codes related to W160 in the Schedule of Benefits include A160.

All codes

W160

W160 – Comprehensive nephrology consultation

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

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Levels of this visit

The W16x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

W164 General re-assessment of patient in nursing home
A general re-assessment of a patient in a non-emergency long-term care setting, such as a nursing home, as per the requirements of the Nursing Homes Act.
$20.60

Consultations

W166 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…
$116.75
W165 Consultation
A consultation provided by a Nephrology (16) specialist to a patient in a non-emergency, long-term care setting.
$180.75
W160 Comprehensive nephrology consultation(this code)
A comprehensive nephrology consultation for a patient in a non-emergency long-term care in-patient service setting.
$342.25

A comprehensive nephrology consultation for a patient in a non-emergency long-term care in-patient service setting. Eligible locations include Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals, other than patients in designated palliative care beds. This service is subject to the same conditions as A160. As a consultation, it requires a written request from a referring physician, nurse practitioner, or dental surgeon who requests the opinion of a specialist because of the complexity, seriousness, or obscurity of the case.

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.

For A160, the start and stop times must be recorded in the patient’s permanent medical record or the amount payable for the service will be adjusted to a lesser paying fee.

A160

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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