What is OHIP billing code W355?

W355 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W355 pay?

The current OHIP fee for W355 is $93.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W355 to OHIP?

W355 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W355 claims against the Schedule of Benefits rules before submission.

What codes are related to W355?

Codes related to W355 in the Schedule of Benefits include W356.

All codes

W355

W355 – Consultation

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

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Levels of this visit

The W35x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W356 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…
$64.90
W355 Consultation(this code)
A urology (35) consultation for a non-emergency patient in a Long-Term Care Institution, which includes chronic care hospitals, convalescent hospitals, nursing homes, and homes…
$93.15

A urology (<specialtyCode>35</specialtyCode>) consultation for a non-emergency patient in a Long-Term Care Institution, which includes chronic care hospitals, convalescent hospitals, nursing homes, and homes for the aged. This service is not for patients in designated palliative care beds. It requires a written request from a referring physician, nurse practitioner, or dental surgeon, and the consultant must provide a written report back. The service includes the necessary history and examination to provide a medical opinion. It may also include physical examination of the genito-urinary tract and procedures such as urethral calibration, catheterization, and prostatic fluid examination. Endoscopic examinations are explicitly excluded and should be billed separately. For emergency calls or special visits, an A-prefix code from the General Listings must be used instead of W355, along with the appropriate Special Visit Premiums.

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 long-term care institution where common medical records are maintained, the written request may be contained on the common medical record.

The written request must identify the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identify 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.

A written report (including findings, opinions, and recommendations) must be prepared and sent to the referring practitioner.

W356

*May include physical examination pertaining to the genito-urinary tract and when necessary such procedures as urethral calibration, catheterization and prostatic fluid examination, but not to include endoscopic examination.

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