What is OHIP billing code W400?

W400 is "Comprehensive community medicine consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W400 pay?

The current OHIP fee for W400 is $270.60, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W400 to OHIP?

W400 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W400 claims against the Schedule of Benefits rules before submission.

What codes are related to W400?

Codes related to W400 in the Schedule of Benefits include A400.

All codes

W400

W400 – Comprehensive community medicine consultation

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

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Levels of this visit

The W40x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W405 Limited consultation
A limited consultation is an assessment that meets all the requirements of a full consultation but is less demanding and, in terms of time, normally requires substantially less of…
$94.75
W400 Comprehensive community medicine consultation(this code)
A comprehensive community medicine consultation rendered to a non-emergency in-patient in a Long-Term Care (LTC) Institution, such as a chronic care hospital, convalescent…
$270.60

A comprehensive community medicine consultation rendered to a non-emergency in-patient in a Long-Term Care (LTC) Institution, such as a chronic care hospital, convalescent hospital, nursing home, or home for the aged. This service is subject to the same conditions as A400. As a consultation, it must be initiated by a written request from a referring physician, nurse practitioner, or dental surgeon, as detailed in . The service includes a comprehensive history and examination appropriate for the patient's complex, serious, or obscure condition, and culminates in a written report with findings, opinions, and recommendations sent 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, 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 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.

The written request sets out the information relevant to the referral and specifies the service(s) required.

Usage limits

OR([1, "24_months", "per_patient_per_physician", "For the same diagnosis."], [1, "12_months", "per_patient_per_physician", "For a clearly defined unrelated diagnosis."])

A400

subject to the same conditions as A400

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

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