What is OHIP billing code W165?

W165 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W165 pay?

The current OHIP fee for W165 is $180.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W165 to OHIP?

W165 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W165 claims against the Schedule of Benefits rules before submission.

What codes are related to W165?

Codes related to W165 in the Schedule of Benefits include W765, W160, W865, W166, A165, C165.

All codes

W165

W165 – 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(this code)
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
A comprehensive nephrology consultation for a patient in a non-emergency long-term care in-patient service setting.
$342.25

A consultation provided by a Nephrology (16) specialist to a patient in a non-emergency, long-term care setting. These settings include Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals (excluding designated palliative care beds). As per the General Preamble (), a consultation requires a written request from a referring physician, nurse practitioner, or dental surgeon, and involves a comprehensive assessment to provide an opinion and recommendations, which are reported 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. In a hospital, long-term care institution or multi-specialty clinic 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 specify the service(s) required.

The consultant must prepare a written report (including findings, opinions, and recommendations) to the referring practitioner.

W765 W160 W865 W166 A165 C165

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.

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