What is OHIP billing code W223?

W223 is "Extended special genetic consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W223 pay?

The current OHIP fee for W223 is $442.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W223 to OHIP?

W223 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W223 claims against the Schedule of Benefits rules before submission.

What codes are related to W223?

Codes related to W223 in the Schedule of Benefits include A223, K016, K222, W225, W220, W325, W226.

All codes

W223

W223 – Extended special genetic consultation

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

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Levels of this visit

The W22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W226 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…
$119.40
W225 Consultation
A consultation service provided by a specialist in Genetics (22).
$190.50
W220 Special genetic consultation
A special genetic consultation rendered to a patient in a non-emergency long-term care institution setting, as defined in GP49.
$342.25
W223 Extended special genetic consultation(this code)
An extended special genetic consultation rendered to a patient in a non-emergency, long-term care in-patient setting.
$442.40

An extended special genetic consultation rendered to a patient in a non-emergency, long-term care in-patient setting. This includes 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 A223. As per the requirements for a consultation on page , this service must be initiated by a written request from a referring physician, nurse practitioner, or dental surgeon and requires a written report to the referring practitioner. A consultation is payable at nil if genetic care (K222) has previously been claimed by the same physician.

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.

The written 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.

A223 K016 K222 W225 W220 W325 W226

A consultation is payable at nil if a genetic assessment (K016) or genetic care (K222) has previously been claimed by the same physician.

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