What is OHIP billing code W515?

W515 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W515 pay?

The current OHIP fee for W515 is $233.65, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W515 to OHIP?

W515 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W515 claims against the Schedule of Benefits rules before submission.

What codes are related to W515?

Codes related to W515 in the Schedule of Benefits include A425, W425, W310, W516, W510, A510, W511, A511.

All codes

W515

W515 – Consultation

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
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(this code)
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 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 & Rehabilitation (31). This service requires a written request from a referring physician, nurse practitioner, or dental surgeon due to the complexity, seriousness, or obscurity of the case, or at the patient's request for another opinion. It includes all the specific elements of an assessment as defined in , including a direct physical encounter, history, and examination. The consulting physician must prepare and send a written report of their findings, opinions, and recommendations to the referring practitioner. A copy of the referral request must be maintained in the patient's medical record. For emergency calls and other special visits to in-patients, use General Listings (A prefix) and 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, 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.

Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.

A425 W425 W310 W516 W510 A510 W511 A511

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, 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 General Listings and Premiums when applicable - see General Preamble to .

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