What is OHIP billing code W405?

W405 is "Limited consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W405 pay?

The current OHIP fee for W405 is $94.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W405 to OHIP?

W405 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W405 claims against the Schedule of Benefits rules before submission.

What codes are related to W405?

Codes related to W405 in the Schedule of Benefits include W055, W050, W400, W056.

All codes

W405

W405 – Limited 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(this code)
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
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 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 the physician's time (see ). As a consultation, it must be initiated by a written request from a referring physician, nurse practitioner, or dental surgeon for an expert opinion. The service includes a review of relevant data, an appropriate history and examination, and a written report of findings and recommendations to the referring practitioner (see ). The W prefix indicates this service is for non-emergency in-patients in a long-term care facility, such as a chronic care hospital, convalescent hospital, nursing home, or home for the aged.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consulting physician's medical record. In a long-term care institution with a common medical record, the written request may be on the common record.

The 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 relevant information and specify the service(s) required.

The consultant must prepare a written report including findings, opinions, and recommendations to the referring practitioner.

W055 W050 W400 W056

This service applies to patients in 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.

For emergency calls and other special visits to in-patients, use General Listings (A prefix) and Special Visit Premiums.

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