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Medical specialties
Clinical Immunology & Allergy OHIP billing codes
Immunology consultations, allergy skin testing and challenge, desensitisation and immunotherapy.
32 codes in 5 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 62 is in the full Clinical Immunology listing.
Consultations & assessments — office
- A625ConsultationConsultation - Clinical Immunology—
- A525Limited consultationLimited consultation - Clinical Immunology—
- A626Repeat ConsultationRepeat Consultation - Clinical Immunology—
- A623Medical Specific AssessmentMedical Specific Assessment - Clinical Immunology—
- A624Medical Specific Re-AssessmentMedical Specific Re-Assessment - Clinical Immunology—
- A621Complex Medical Specific Re-AssessmentComplex medical specific re-assessment—
- A628Partial Assessment—
Hospital in-patient
- C625ConsultationA consultation by a Clinical Immunology specialist for a non-emergency hospital in-patient, requested by a referring practitioner, which includes a comprehensive assessment and a written report.—
- C525Limited consultationA limited consultation by a Clinical Immunology specialist for a non-emergency hospital in-patient. This service is less demanding and requires less time than a full consultation but must meet all other requirements of a consultation, including a written request and report.—
- C626Repeat ConsultationA repeat consultation provided by a Clinical Immunology specialist to a non-emergency hospital in-patient for the same presenting problem, requiring a new written request from the referring practitioner.—
- C623Medical Specific AssessmentA medical specific assessment for a non-emergency hospital in-patient by a Clinical Immunology specialist.—
- C624Medical Specific Re-AssessmentA medical specific re-assessment for a non-emergency hospital in-patient, rendered by a Clinical Immunology specialist. This service requires a full, relevant history and physical examination of one or more systems.—
- C621Complex Medical Specific Re-AssessmentA complex medical specific re-assessment for a non-emergency hospital in-patient, rendered by a Clinical Immunology specialist, due to the complexity, obscurity, or seriousness of the patient's condition. This service requires a written report to the patient's primary care physician.—
- C622Subsequent Visit - First Five WeeksA routine subsequent visit by a Clinical Immunology specialist (specialty 62) to a non-emergency hospital in-patient during the first five weeks of their admission.—
- C627Subsequent Visit - Sixth to Thirteenth Week InclusiveA subsequent hospital in-patient visit for a Clinical Immunology patient, from the sixth to the thirteenth week of admission. This service is limited to a maximum of three visits per patient per week.—
- C629Subsequent Visit - After Thirteenth WeekA subsequent visit by a Clinical Immunology (62) specialist for a non-emergency hospital in-patient, after the 13th week of admission. This service is limited to a maximum of 6 visits per patient per month.—
- C628Concurrent CareA routine assessment rendered in hospital by a consultant providing continued directive care at the request of the patient's most responsible physician (MRP).—
Allergy testing & interpretation
- G197Skin testing - professional componentThe professional component of an allergy skin test. This service covers the physician's work in interpreting the test and is limited to 50 tests per patient per year.$0.39
- G209Skin testing - technical componentTechnical component for performing a skin test. This service is limited to a maximum of 50 per year per test.$0.80
- G195Local anaesthetic hypersensitivity skin testA skin test to investigate potential hypersensitivity to local anaesthetics. This service is limited to a maximum of two per patient, per physician, per 12-month period.$17.00
- G196Hypersensitivity skin test for validated drugs or agentsA hypersensitivity skin test for validated drugs or agents, excluding foods and inhalants. This service is limited to a maximum of 3 per patient, per physician, per 12-month period, and has a specific add-on (<billingCode>E582</billingCode>) for penicillin testing outside a hospital.$17.00
- G199Venom allergy testingVenom allergy testing involves investigations like skin prick and intracutaneous tests to determine venom allergy's role in a patient's illness. This service is limited to twice per patient, per physician, per 12-month period.$40.00
- G206Patch testmaximum of 90 per patient, per year (per test)$2.39
- K399Clinical interpretation by an immunologistA clinical interpretation by an immunologist, involving review of data and tests, which requires a written report to the patient's physician. Not payable with a consultation.$29.05
- J330Assessment of exercise induced asthmaA diagnostic test to assess for exercise-induced asthma, involving spirometry before and after a period of exercise sufficient to raise the heart rate to a target level.—
- J335Antigen challenge testAn antigen challenge test, a type of bronchial provocative test, with separate billable technical (H) and professional (P) components.—
Immunotherapy & desensitisation
- G202Hyposensitisation - each injectionFee for each individual hyposensitisation (allergy) injection. This code has specific payment limits when billed with an assessment or alongside <billingCode>G212</billingCode>.$7.15
- G212Hyposensitisation - when sole reason for visitPayable for a visit where a hyposensitization injection is the sole service provided. This fee includes the first injection.$12.85
- G205Insect venom desensitisation (immunotherapy)Per-injection fee for insect venom desensitisation (immunotherapy), billable up to five times per day. Under certain conditions, a minor or partial assessment may also be claimed on the same day.$13.15
- G200Acute desensitisationA diagnostic and therapeutic procedure for acute desensitization to substances such as antitoxin serum (ATS) or penicillin.$8.65
- G185Drug(s) desensitisationDrug(s) desensitisation performed in a hospital setting where there is a significant risk of life-threatening anaphylaxis. This requires full cardioresuscitative equipment to be readily available and direct, ongoing physician attendance.$184.95
How to use this allergy code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to clinical immunology (specialty 62) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a allergy physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does clinical immunology & allergy bill?
The consultations & assessments — office section of this set starts with A625 (Consultation). 7 codes are listed in that section.
What is in the Clinical Immunology & Allergy code set?
32 OHIP billing codes across 5 sections: Consultations & assessments — office; Hospital in-patient; Allergy testing & interpretation; Immunotherapy & desensitisation; Premiums. Immunology consultations, allergy skin testing and challenge, desensitisation and immunotherapy.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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