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Medical specialties
Neurology OHIP billing codes
Neurology consultations and complex assessments, stroke management, EEG, EMG and nerve conduction, botulinum toxin, movement disorder procedures.
61 codes in 10 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 18 is in the full Neurology listing.
Consultations & assessments — office
- A185Complex neurological assessmentConsultation—
- A180Special neurology consultationComplex neurological assessment—
- A385Limited ConsultationLimited Consultation - Neurology—
- A682Complex neurological assessmentExtended special neurology consultation (minimum 90 minutes)—
- A183Complex neurological assessmentA complex neurological assessment is an assessment for the ongoing management of the following complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and where the visit requires a minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient: 1. the following diseases of the neuromuscular system a. generalized peripheral neuropathies; b. myopathies; c. diseases of the neuromuscular junction; or d. diseases of the motor neurone. 2. the following chronic central nervous system disorders: a. Malignant neoplasms (brain) b. Psychosomatic disturbances (functional neurological disorder) c. Chronic migraine or trigeminal autonomic cephalalgias d. Huntington’s chorea e. Trigeminal neuralgia f. Intracranial hemorrhage g. Stroke—
- A184Complex neurological assessmentComplex neurological assessment (Medical specific re-assessment)—
- A186Complex neurological assessment—
- A188Complex neurological assessmentA complex neurological assessment is an assessment for the ongoing management of the following complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and where the visit requires a minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient: 1. the following diseases of the neuromuscular system a. generalized peripheral neuropathies; b. myopathies; c. diseases of the neuromuscular junction; or d. diseases of the motor neurone. 2. the following chronic central nervous system disorders: a. Malignant neoplasms (brain) b. Psychosomatic disturbances (functional neurological disorder) c. Chronic migraine or trigeminal autonomic cephalalgias d. Huntington’s chorea e. Trigeminal neuralgia f. Intracranial hemorrhage g. Stroke—
- A181Complex medical specific re-assessmentA re-assessment by a neurologist for a patient with a complex, obscure, or serious condition. This service includes a full history and examination of the affected systems and requires a written report to the primary care physician.—
- A113Complex neuromuscular assessmentComplex neurological assessment—
- A384Medical Specific Re-AssessmentConsultation and Management for Acute Cerebral Vascular Syndrome (ACVS)—
Hospital in-patient & stroke
- C185ConsultationNeurology consultation for a non-emergency hospital in-patient. This service requires a written request from a referring practitioner for an expert opinion due to the complexity, seriousness, or obscurity of the case.—
- C180Special neurology consultationA special neurology consultation for a non-emergency hospital in-patient, requiring a minimum of 75 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention.—
- C682Extended Special Neurology ConsultationExtended special neurology consultation for a non-emergency hospital in-patient. This service is subject to the same conditions as <billingCode>A682</billingCode>.—
- C385Limited consultationA limited consultation rendered by a specialist in Neurology (18) to a non-emergency hospital in-patient. This service is less demanding and requires less time than a full consultation but must still meet all the requirements of a consultation, including a written request.—
- C186Repeat consultationA repeat consultation for a Neurology (18) patient in a non-emergency acute care hospital setting. This service requires a new written referral for the same presenting problem, following care by another physician since the initial consultation.—
- C183Medical specific assessmentA medical specific assessment for a non-emergency hospital in-patient, rendered by a neurologist, requiring a detailed history and examination of the affected systems.—
- C184Medical specific re-assessmentA medical specific re-assessment rendered by a neurologist to a non-emergency hospital in-patient. This service requires a full, relevant history and physical examination of one or more systems.—
- C181Complex medical specific re-assessmentA complex medical specific re-assessment for a non-emergency hospital in-patient, performed due to the complexity, obscurity, or seriousness of the patient's condition.—
- C182Subsequent visit - first five weeksA routine assessment in a hospital setting for a non-emergency in-patient by a Neurologist during the first five weeks of admission, limited to one per day.—
- C187Subsequent visit - sixth to thirteenth week inclusiveA subsequent hospital in-patient visit by a Neurology specialist for a patient who has been admitted for the sixth to the thirteenth week, inclusive. This service has a maximum of three visits per patient, per week.—
- C189Subsequent visit - after thirteenth weekA subsequent visit by a Neurologist to a non-emergency, acute care hospital in-patient, rendered after the thirteenth week of admission. Limited to a maximum of six visits per patient per month.—
- C188Concurrent careA subsequent visit rendered in a nursing home or home for the aged, with a maximum of 3 per patient per month.—
- C113Complex neuromuscular assessmentComplex neurological assessment—
- C384Consultation and Management for ACVSA consultation and management service for Acute Coordinated Vascular Services (ACVS) for a non-emergency hospital in-patient, performed by a neurologist. This service follows the same conditions as billing code `<billingCode>A384</billingCode>`.—
- K181Consultation and Management for Acute Cerebral Vascular Syndrome (ACVS) - after first 30 minutes, must include intravenous thrombolysis therapy and monitoring, per 30 minute unit (or major part thereof)Consultation and Management for Acute Cerebral Vascular Syndrome (ACVS) - after first 30 minutes, must include intravenous thrombolysis therapy and monitoring, per 30 minute unit (or major part thereof). This service is eligible for payment for patients seen within the timeframe for eligibility for intravenous thrombolysis therapy and treated with intravenous thrombolysis therapy as defined by the Canadian Stroke Best Practices. It must be rendered in a hospital with CT or MRI facilities onsite by a specialist in Neurology (18), who remains in constant attendance with the patient.—
EEG
- G415Routine EEG - professional componentThe professional component fee for the interpretation of a routine electroencephalogram (EEG). A routine EEG involves at least a twenty-minute recording with hyperventilation and photic stimulation where clinically possible.$23.15
- G418Routine EEG - professional component (16 - 21 channel EEG)Professional component for a routine Electroencephalogram (EEG) using 16 to 21 channels, which includes the interpretation and reporting of the EEG recording.$62.50
- G496EEG with time-locked video recording - professional componentProfessional component for the interpretation of an electroencephalogram (EEG) with a time-locked video recording, which requires at least 30 minutes of recording, a minimum of 16 channels, and recordings of at least two physiological parameters.$120.00
- G543Sleep-deprived/induced EEG - professional componentThe professional component for a sleep-deprived or sleep-induced electroencephalogram (EEG). This service involves the interpretation of an EEG recording lasting at least 60 minutes with a minimum of 16 channels and recordings of at least two physiological parameters.$120.00
- G555Ambulatory EEG monitoring - professional componentProfessional component for the interpretation and reporting of a 12 to 24-hour ambulatory EEG monitoring study.$120.00
- G413Electrocorticogram - supervision and interpretationSupervision and interpretation of an electrocorticogram. This service is not payable if claimed on the same day for the same patient as <billingCode>G267</billingCode> (intra-operative evaluation of a movement disorder patient).$170.85
- G417Inserting subtemporal needle electrodesAn add-on procedure for the insertion of subtemporal needle electrodes, performed in conjunction with another primary electrophysiological assessment.$15.90
EMG, nerve conduction & evoked potentials
- G456Professional component of complete needle electromyography and nerve conduction studiesProfessional component for a comprehensive electromyography (EMG) and nerve conduction study (NCS), involving two or more nerves and associated muscles.$120.00
- G473Complex neuromuscular electrodiagnostic testing - professional componentThe professional component for a comprehensive ('Schedule C') nerve conduction study (NCS) and electromyography (EMG) for complex neuromuscular disorders. Requires a minimum of 60 minutes of procedure time.$275.00
- G455Technical component of complete EMG/NCS procedureTechnical component for a complete electromyography (EMG) and nerve conduction study (NCS) on two or more nerves, also known as a Schedule A procedure. This service is related to its professional component counterpart, <billingCode>G456</billingCode>.$31.80
- G138Professional componentProfessional component for an evoked potentials test of the upper or lower limbs. This service is payable at 50% of the fee if only one limb is tested.$71.65
- G140Evoked potentials - technical componentTechnical component for performing evoked potential tests on the upper or lower limbs. This fee is reduced by 50% if only a single limb is tested and is adjusted to 86.10% of the listed fee when rendered in a hospital.$46.60
Botulinum toxin & chemodenervation
- G485Chemodenervation injection - first major nerve and/or branchesProvides for the chemodenervation of a single major peripheral motor nerve or its branches using agents like phenol or alcohol to reduce focal spasticity, with optional EMG guidance.$45.45
- G486Chemodenervation injection - each additional major nerve and/or its branchesThis is an add-on code for the chemodenervation of each additional major nerve on the same day, following an initial injection (<billingCode>G485</billingCode>). This procedure uses non-anaesthetic chemical agents to reduce focal spasticity.$28.50
- G487Chemodenervation injection - first major nerve and/or its branches (repeat or additional procedure within 30 days)A repeat or additional chemodenervation injection of the first major nerve or its branches, using agents like phenol or alcohol, for focal spasticity. This procedure must be performed within 30 days of a prior chemodenervation injection.$28.50
- G488Chemodenervation injection - each additional major nerve and/or its branches same dayAn add-on for the chemodenervation of each additional major nerve (and/or its branches), when performed as a repeat or supplementary procedure within 30 days of a prior chemodenervation injection.$18.80
- G871Botulinum toxin injection(s) for blepharospasmProvides for the injection of botulinum toxin to treat blepharospasm (involuntary eyelid muscle contraction). This service is payable for treatment of one or both eyes.$120.00
- G872Botulinum toxin injection(s) for hemifacial spasmBotulinum toxin injection(s) for hemifacial spasm, (unilateral or bilateral)$120.00
- G875Botulinum toxin injection - first injectionFirst botulinum toxin injection for the treatment of Oromandibular dystonia, limb dystonia, cervical dystonia, or spasticity.$40.00
- G876Botulinum toxin injection - each additional injectionFee for each additional botulinum toxin injection administered for conditions like dystonia or spasticity. This code is billed in conjunction with <billingCode>G875</billingCode> and is limited to a maximum of 11 units.$10.00
- G877EMG and/or ultrasound guidance for Botulinum toxin injection (one injection)An add-on service providing Electromyography (EMG) guidance for a single Botulinum toxin injection. This service is payable with `<billingCode>G870</billingCode>`, `<billingCode>G873</billingCode>`, `<billingCode>G874</billingCode>`, or `<billingCode>G875</billingCode>` when EMG is required to determine the injection site.$18.85
Movement disorders & deep brain stimulation
- G266Electrophysiological assessment of movement disordersAn electrophysiological assessment for movement disorders, which involves multi-channel recording of EEG and EMG with various analyses. This service requires a minimum of three hours, during which the physician must be physically present throughout.$278.85
- G267Intra-operative evaluation of movement disorder patient during functional neurosurgeryProvides for the intra-operative evaluation of a patient with a movement disorder during functional neurosurgery. This service is not payable with assistant units or at the same time as an electrocorticogram (`<billingCode>G413</billingCode>`).$270.05
- G548Electrophysiological assessment of Deep Brain StimulatorsElectrophysiological assessment of Deep Brain Stimulators (DBS), requiring a minimum of 3 hours with the physician physically present throughout.$278.85
- G549Clinical Programming of Deep Brain Stimulator - additional implantation siteProvides for the clinical programming of an additional Deep Brain Stimulator (DBS) implantation site(s). This service is subject to a maximum of one per patient, as outlined on page J83.$157.85
Procedures
- Z804Lumbar puncturePerforms a lumbar puncture (spinal tap), a procedure to collect cerebrospinal fluid. This service includes the injection of medication and the use of image guidance, if performed.$150.00
- G410Amytal test (Wada)-bilateral - supervision and co-ordination of testsPayable for the physician's supervision and co-ordination of a bilateral Amytal (Wada) test, a diagnostic procedure in neurology.$68.40
Neurocognitive assessment
Long-term care
- W185Consultation - Non-Emergency Long-Term Care In-Patient ServicesA non-emergency consultation provided by a Neurologist to a patient in a long-term care institution. This service requires a written request from a referring practitioner.—
- W186Repeat consultationA repeat neurology consultation for a patient in a long-term care institution. This service requires a new written request from a referring practitioner for the same problem as an initial consultation, after the patient has received care from another physician in the interim.—
- W385Limited consultationA limited consultation by a neurologist for a non-emergency in-patient in a Long-Term Care Institution. It is less demanding than a full consultation but has the same referral and documentation requirements.—
- W180Special neurology consultationA special neurology consultation rendered to an in-patient of a long-term care facility. This service is subject to the same conditions as billing code <billingCode>A180</billingCode>.—
- W682Extended special neurology consultationAn extended special neurology consultation for a non-emergency in-patient in a long-term care facility, provided by a neurologist and subject to the same conditions as <billingCode>A682</billingCode>.—
- W184General re-assessment of patient in nursing homeA general re-assessment for a patient in a nursing home, as defined by the *Nursing Homes Act*. This service involves a re-evaluation of the patient but may rely on a previously obtained medical history.—
How to use this neurology code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to neurology (specialty 18) — 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 neurology 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 neurology bill?
The consultations & assessments — office section of this set starts with A185 (Complex neurological assessment). 11 codes are listed in that section.
What is in the Neurology code set?
61 OHIP billing codes across 10 sections: Consultations & assessments — office; Hospital in-patient & stroke; Premiums; EEG; EMG, nerve conduction & evoked potentials; Botulinum toxin & chemodenervation; Movement disorders & deep brain stimulation; Procedures; Neurocognitive assessment; Long-term care. Neurology consultations and complex assessments, stroke management, EEG, EMG and nerve conduction, botulinum toxin, movement disorder procedures.
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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