What is OHIP billing code W725?

W725 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W725 pay?

The current OHIP fee for W725 is $192.85, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W725 to OHIP?

W725 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W725 claims against the Schedule of Benefits rules before submission.

What codes are related to W725?

Codes related to W725 in the Schedule of Benefits include A725, C725, W720, W726, W925.

All codes

W725

W725 – Consultation

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

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Levels of this visit

The W72x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W726 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$123.10
W725 Consultation(this code)
A consultation rendered by a specialist in occupational medicine to a patient in a non-emergency long-term care in-patient setting, including chronic care hospitals, convalescent…
$192.85
W720 Comprehensive occupational medicine consultation
A comprehensive occupational medicine consultation rendered to a patient in a non-emergency long-term care in-patient setting (chronic care hospitals, convalescent hospitals…
$342.25

A consultation rendered by a specialist in occupational medicine to a patient in a non-emergency long-term care in-patient setting, including chronic care hospitals, convalescent hospitals, nursing homes, and homes for the aged.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Requires a written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure in a hospital).

The consultant must provide a written report (including findings, opinions, and recommendations) to the referring provider.

A copy of the written request must be kept in the patient's medical record (or common medical record in LTC).

The request must identify the consultant, the referring provider (name and billing number), and the patient (name and health number).

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

Usage limits

Limited to one consultation per patient by the same physician for the same diagnosis per two consecutive 12-month periods (except for repeat consultations or specific hospital/ED exceptions).

A725Consultation (Office)C725Consultation (Hospital In-patient)W720Comprehensive occupational medicine consultation (LTC)W726Repeat consultation (LTC)W925Limited consultation (LTC)

W725 is the LTC equivalent of the office consultation A725.

If the consultation is requested by a Medical Trainee, the fee is adjusted to a lesser assessment fee.

Special visit premiums (travel and person seen) are generally not eligible for payment with W-prefix codes as they are designated for non-emergency/routine care.

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