What is OHIP billing code W225?

W225 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W225 pay?

The current OHIP fee for W225 is $190.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W225 to OHIP?

W225 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W225 claims against the Schedule of Benefits rules before submission.

What codes are related to W225?

Codes related to W225 in the Schedule of Benefits include A225, C225, K016, K222.

All codes

W225

W225 – 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(this code)
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
An extended special genetic consultation rendered to a patient in a non-emergency, long-term care in-patient setting.
$442.40

A consultation service provided by a specialist in Genetics (22). This service is for non-emergency in-patients 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. It requires a written request from a referring practitioner and involves a comprehensive assessment to provide an opinion on a complex, serious, or obscure case, with a written report sent back to the referring source. This service is subject to the general rules for consultations as outlined in the Schedule of Benefits.

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.

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

A225 C225 K016 K222

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