What is OHIP billing code W265?

W265 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W265 pay?

The current OHIP fee for W265 is $190.35, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W265 to OHIP?

W265 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W265 claims against the Schedule of Benefits rules before submission.

What codes are related to W265?

Codes related to W265 in the Schedule of Benefits include W260, W662, W667, W565, W266.

All codes

W265

W265 – Consultation

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

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Levels of this visit

The W26x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W266 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care rendered to the patient by another physician in…
$104.70
W265 Consultation(this code)
Consultation listed under Paediatrics (26), Non-Emergency Long-Term Care In-Patient Services.
$190.35
W260 Special paediatric consultation
Non-Emergency Long-Term Care In-Patient Services include chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent…
$342.25

Consultation listed under Paediatrics (26), Non-Emergency Long-Term Care In-Patient Services. These include Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use the General Listings and premiums when applicable (General Preamble to ).

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

W260 W662 W667 W565 W266

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .

In surgical cases requiring medical direction, standard in-hospital medical fees are to be claimed in addition to the surgical fee. This includes all operations on babies under one year of age, and all other older children who require medical supervision.

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