What is OHIP billing code W511?

W511 is "Complex physiatry assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W511 pay?

The current OHIP fee for W511 is $114.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W511 to OHIP?

W511 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W511 claims against the Schedule of Benefits rules before submission.

What codes are related to W511?

Codes related to W511 in the Schedule of Benefits include A511, W515, W425, W310, W516, W510.

All codes

W511

W511 – Complex physiatry assessment

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

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Levels of this visit

The W51x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

W510 Complex neuromuscular assessment
A complex neuromuscular assessment rendered to a non-emergency in-patient in a Long-Term Care Institution.
$104.85
W511 Complex physiatry assessment(this code)
A complex physiatry assessment for a non-emergency in-patient in a Long-Term Care Institution, which includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, and…
$114.80

Consultations

W516 Repeat consultation
A repeat consultation rendered by a Physical Medicine & Rehabilitation (31) specialist for a patient in a non-emergency long-term care institution.
$106.60
W515 Consultation
A consultation rendered in a non-emergency long-term care in-patient setting (e.g., Chronic Care Hospital, Nursing Home, Home for the Aged) by a specialist in Physical Medicine &…
$233.65

A complex physiatry assessment for a non-emergency in-patient in a Long-Term Care Institution, which includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, and Homes for the Aged (). This service is subject to the same conditions as billing code A511. As per the General Preamble, all assessments must include a direct physical encounter with the patient, taking a patient history, performing a physical examination, and arranging any necessary follow-up care or procedures (). This 'W' prefix code is designated for non-emergency services; for emergency calls or other special visits to these patients, the 'A' prefix General Listings and appropriate Special Visit Premiums should be used (, ).

Must include the elements of a medical specific re-assessment, or the amount payable will be adjusted to a lesser assessment fee.

A511 W515 W425 W310 W516 W510

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