Family practice & practice in general OHIP billing codes


General Listings

Code Description Amount Ans Units Assist Units
A005 Consultation $77.20 N/A N/A
A911 Special family and general practice consultation $144.75 N/A N/A
A912 Comprehensive family and general practice consultation $217.15 N/A N/A
A945 Special palliative care consultation $144.75 N/A N/A
A905 Limited consultation $65.90 N/A N/A
A006 Repeat consultation $45.90 N/A N/A
A003 General assessment $77.20 N/A N/A
A004 General re-assessment $38.35 N/A N/A
A888 Emergency department equivalent - partial assessment $33.70 N/A N/A
A901 House call assessment $45.15 N/A N/A
A900 Complex house call assessment $45.15 N/A N/A
A902 House call assessment - Pronouncement of death in the home $45.15 N/A N/A
A903 Pre-dental/ pre-operative general assessment $65.05 N/A N/A
A904 Pre-dental/ pre-operative assessment $33.70 N/A N/A
A933 On-call admission assessment $79.90 N/A N/A
A100 General/Family physician emergency department assessment $76.90 N/A N/A
A771 Certification of death $20.60 N/A N/A
A777 Intermediate assessment Pronouncement of death (see General Preamble GP18) $33.70 N/A N/A
A002 Enhanced 18 month well baby visit (see General Preamble GP22) $62.20 N/A N/A
A007 Intermediate assessment or well baby care $33.70 N/A N/A
A001 Minor assessment $21.70 N/A N/A
A917 Sport medicine FPA $33.70 N/A N/A
A927 Allergy FPA $33.70 N/A N/A
A937 Pain management FPA $33.70 N/A N/A
A947 Sleep medicine FPA $33.70 N/A N/A
A957 Addiction medicine FPA $33.70 N/A N/A
A967 Care of the elderly FPA $33.70 N/A N/A
A008 Mini assessment $13.05 N/A N/A
K017 Periodic health visit - child $43.60 N/A N/A
K130 Periodic health visit - adolescent $77.20 N/A N/A
K131 Periodic health visit - adult age 18 to 64 inclusive $50.00 N/A N/A
K132 Periodic health visit - adult 65 years of age and older $77.20 N/A N/A
A110 Periodic oculo-visual assessment - aged 19 years and below $48.90 N/A N/A
A112 Periodic oculo-visual assessment - aged 65 years and above $48.90 N/A N/A
E077 - Identification of patient for a major eye examination $0.00 N/A N/A
A115 Major eye examination $51.10 N/A N/A
A816 Midwife-Requested Anaesthesia Assessment (MRAA) $106.80 N/A N/A
A813 Midwife-Requested Assessment (MRA) $101.70 N/A N/A
A815 Midwife-Requested Special Assessment (MRSA) $186.95 N/A N/A

Non Emergency Hospital In Patient Services

Code Description Amount Ans Units Assist Units
C005 Consultation $77.20 N/A N/A
C911 Special family and general practice consultation ­ subject to the same conditions as A911 $144.75 N/A N/A
C912 Comprehensive family and general practice consultation ­ subject to the same conditions as A912 $217.15 N/A N/A
C945 Special palliative care consultation ­ subject to the same conditions as A945 $144.75 N/A N/A
C905 Limited consultation $65.90 N/A N/A
C006 Repeat consultation $45.90 N/A N/A
C003 General assessment $77.20 N/A N/A
C004 General re-assessment $38.35 N/A N/A
C816 Midwife-Requested Anaesthesiologist Assessment (MRAA) - subject to the same conditions as A816 $106.80 N/A N/A
C813 Midwife-Requested Assessment - subject to the same conditions as A813 $101.70 N/A N/A
C815 Midwife-Requested Special Assessment - subject to the same conditions as A815 $186.95 N/A N/A
C903 Pre-dental/pre-operative general assessment (maximum of 2 per 12 month period) $65.05 N/A N/A
C904 Pre-dental/pre-operative assessment $33.70 N/A N/A
C933 On-call admission assessment - subject to the same conditions as A933 $79.90 N/A N/A
C777 Intermediate assessment - Pronouncement of death - subject to the same conditions as A777 $33.70 N/A N/A
C771 Certification of death - subject to the same conditions as A771 $20.60 N/A N/A
C002 Subsequent visits - First 5 Weeks … per visit $31.00 N/A N/A
C007 Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) … per visit $31.00 N/A N/A
C009 Subsequent visits - after thirteenth week (maximum 6 per patient per month) … per visit $31.00 N/A N/A
C122 Subsequent visits by the Most Responsible Physician (MRP) - day following the hospital admission assessment $58.80 N/A N/A
C123 Subsequent visits by the Most Responsible Physician (MRP) - second day following the hospital assessment $58.80 N/A N/A
C124 Subsequent visits by the Most Responsible Physician (MRP) - day of discharge $58.80 N/A N/A
C142 Subsequent visits by the MRP following transfer from an Intensive Care Area - first subsequent visit by the MRP following transfer from an Intensive Care Area $58.80 N/A N/A
C143 Subsequent visits by the MRP following transfer from an Intensive Care Area -second subsequent visit by the MRP following transfer from an Intensive Care Area $58.80 N/A N/A
C121 Subsequent visits by the MRP following transfer from an Intensive Care Area - Additional visits due to intercurrent illness (see General Preamble GP28) … per visit $31.00 N/A N/A
C008 Subsequent visits by the MRP following transfer from an Intensive Care Area - Concurrent care … per visit $31.00 N/A N/A
C010 Subsequent visits by the MRP following transfer from an Intensive Care Area - Supportive care … per visit $18.85 N/A N/A
C882 Subsequent visits by the MRP following transfer from an Intensive Care Area - Palliative care (see General Preamble GP34) … per visit $31.00 N/A N/A

Other

Code Description Amount Ans Units Assist Units
H007 Attendance at maternal delivery for care of high risk baby(ies) $61.65 N/A N/A
H001 Newborn care in hospital and/or home $52.20 N/A N/A
H002 Low birth weight baby care (uncomplicated) - initial visit (per baby) $32.75 N/A N/A
H003 Low birth weight baby care (uncomplicated) - subsequent visit … per visit $16.25 N/A N/A
K682 Opioid Agonist Maintenance Program monthly management fee - intensive, per month $45.00 N/A N/A
K684 - Opioid Agonist Maintenance Program team premium, per month, to K682 or K683 $6.00 N/A N/A
K683 Opioid Agonist Maintenance Program monthly management fee - maintenance, per month $38.00 N/A N/A
K684 - Opioid Agonist Maintenance Program team premium, per month, to K682 or K683 $6.00 N/A N/A
H065 Consultation in Emergency Medicine $74.25 N/A N/A
H105 In-patient interim admission orders $26.25 N/A N/A
H102 Comprehensive assessment and care - Monday to Friday - Daytime (08:00h to 17:00h) $37.20 N/A N/A
H103 Multiple systems assessment - Monday to Friday - Daytime (08:00h to 17:00h) $35.65 N/A N/A
K002 Family meeting, caregiver interview $62.75 N/A N/A
K005 Primary mental health care – Individual care $62.75 N/A N/A
K007 Psychotherapy - Individual care $62.75 N/A N/A
K013 Counselling - Individual care $62.75 N/A N/A
K014 Counselling for transplant recipients, donors or families of recipients and donors $62.75 N/A N/A
K015 Counselling of relatives - on behalf of catastrophically or terminally ill patient $62.75 N/A N/A
K032 Specific neurocognitive assessment $62.75 N/A N/A
K040 Group counselling $62.75 N/A N/A
K121 Hospital in-patient case conference $31.35 N/A N/A
K035 Mandatory reporting of medical condition to the Ontario Ministry of Transportation $36.25 N/A N/A
K038 Completion of Long-Term Care health report form $45.15 N/A N/A
K070 Home care application $31.75 N/A N/A
K730 Physician to physician telephone consultation - Referring physician $31.35 N/A N/A
K731 Physician to physician telephone consultation - Consultant physician $40.45 N/A N/A
K732 CritiCall telephone consultation - Referring physician $31.35 N/A N/A
K738 Physician to physician e-consultation – Referring physician $16.00 N/A N/A
K623 Application for psychiatric assessment $104.80 N/A N/A
H101 Minor assessment - Monday to Friday - Daytime (08:00h to 17:00h) $15.00 N/A N/A
H104 Re-assessment - Monday to Friday - Daytime (08:00h to 17:00h) $15.00 N/A N/A
H132 Comprehensive assessment and care - Monday to Friday - Evenings (17:00h to 24:00h) $46.30 N/A N/A
H133 Multiple systems assessment - Monday to Friday - Evenings (17:00h to 24:00h) $42.40 N/A N/A
H131 Minor assessment - Monday to Friday - Evenings (17:00h to 24:00h) $18.70 N/A N/A
H134 Re-assessment - Monday to Friday - Evenings (17:00h to 24:00h) $18.70 N/A N/A
H152 Comprehensive assessment and care - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h) $63.30 N/A N/A
H153 Multiple systems assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h) $56.95 N/A N/A
H151 Minor assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h) $25.50 N/A N/A
H154 Re-assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h) $25.50 N/A N/A
H122 Comprehensive assessment and care - Nights (00:00h to 08:00h) $73.90 N/A N/A
H123 Multiple systems assessment - Nights (00:00h to 08:00h) $65.95 N/A N/A
H121 Minor assessment - Nights (00:00h to 08:00h) $29.80 N/A N/A
H124 Re-assessment - Nights (00:00h to 08:00h) $29.80 N/A N/A
H112 Other service rendered by Emergency Department Physician in premium hours - nights (00:00h to 08:00h) $34.20 N/A N/A
H113 Other service rendered by Emergency Department Physician in premium hours - daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays $19.80 N/A N/A
H100 Emergency department investigative ultrasound $19.65 N/A N/A
W105 Consultation - Long-Term Care In-Patient $77.20 N/A N/A
W911 Special family and general practice consultation _ subject to the same conditions as A911 $144.75 N/A N/A
W912 Comprehensive family and general practice consultation _ subject to the same conditions as A912 $217.15 N/A N/A
W106 Repeat consultation $45.90 N/A N/A
W102 Admission assessment - Type 1 $69.35 N/A N/A
W104 Admission assessment - Type 2 $20.60 N/A N/A
W107 Admission assessment - Type 3 $30.70 N/A N/A
W109 Periodic health visit $70.50 N/A N/A
W777 Intermediate assessment _ Pronouncement of death _ subject to the same conditions as A777 $33.70 N/A N/A
W771 Certification of death _ subject to same conditions as A771 $20.60 N/A N/A
W004 General re_assessment of patient in nursing home (per the Nursing Homes Act) $38.35 N/A N/A
W903 Pre_dental/pre_operative general assessment (maximum of 2 per 12 month period) $65.05 N/A N/A
W904 Pre_dental/pre_operative assessment $33.70 N/A N/A
W002 Chronic care or convalescent hospital - first 4 subsequent visits per patient per month (per visit) $32.20 N/A N/A
W001 Chronic care or convalescent hospital - additional subsequent visits (maximum 4 per patient per month) per visit $21.20 N/A N/A
W882 Chronic care or convalescent hospital - palliative care (see General Preamble GP34) per visit $32.20 N/A N/A
W003 Nursing home or home for the aged - first 2 subsequent visits per patient per month (per visit) $32.20 N/A N/A
W008 Nursing home or home for the aged - additional subsequent visits (maximum 2 per patient per month) per visit $21.20 N/A N/A
W872 Nursing home or home for the aged - palliative care (see General Preamble GP34) per visit $32.20 N/A N/A
W121 Additional visits due to intercurrent illness (see General Preamble GP33) per visit $31.00 N/A N/A
W010 Monthly management fee (per patient per month) (see General Preamble GP35 to GP36) $108.85 N/A N/A
K033 Counselling individual care - additional units per patient per provider per 12 month period (per unit) $38.15 N/A N/A
K041 Group counselling - 2 or more persons - additional units where any group member has received 3 or more units of any counselling paid under codes K013 and K040 combined per provider per 12 month period (per unit) $38.80 N/A N/A
K140 Chronic disease shared appointment - 2 patients (per unit) $31.40 N/A N/A
K141 Chronic disease shared appointment - 3 patients (per unit) $20.90 N/A N/A
K142 Chronic disease shared appointment - 4 patients (per unit) $15.80 N/A N/A
K143 Chronic disease shared appointment - 5 patients (per unit) $13.00 N/A N/A
K144 Chronic disease shared appointment - 6 to 12 patients (per unit) $11.05 N/A N/A
K019 Psychotherapy - Group 2 people (per unit) $31.40 N/A N/A
K020 Psychotherapy - Group 3 people (per unit) $20.90 N/A N/A
K012 Psychotherapy - Group 3 people (per unit) $15.80 N/A N/A
K024 Psychotherapy - Group 5 people (per unit) $13.00 N/A N/A
K025 Psychotherapy - Group 6 to 12 people (per unit) $11.05 N/A N/A
K010 Psychotherapy - additional units per member (maximum 6 units per patient per day) $10.00 N/A N/A
K004 Psychotherapy - Family (2 or more family members in attendance at the same time) per unit $68.10 N/A N/A
K006 Hypnotherapy - Individual care $62.75 N/A N/A
K624 Certification of involuntary admission $129.05 N/A N/A
K629 All other re_certification(s) of involuntary admission including completion of appropriate forms $38.25 N/A N/A
K887 CTO initiation including completion of the CTO form and all preceding CTO services directly related to CTO initiation (per unit) $84.70 N/A N/A
K888 CTO supervision including all associated CTO services except those related to initiation or renewal (per unit) $84.70 N/A N/A
K889 CTO renewal including completion of the CTO form and all preceding CTO services directly related to CTO renewal (per unit) $84.70 N/A N/A
K003 Interviews with Children's Aid Society (CAS) or legal guardian on be half of the patient in accordance with the Health Care Consent Act conducted for a purpose other than to obtain consent (per unit) $62.75 N/A N/A
K008 Diagnostic interview and/or counselling with child and/or parent for psychological problem or learning disabilities (per unit) $62.75 N/A N/A
K708 MCC Participant, per patient $31.35 N/A N/A
K709 MCC Chairperson, per patient $40.45 N/A N/A
K710 MCC Radiologist Participant, per patient $31.35 N/A N/A
K700 Palliative care out_patient case conference (per unit) $31.35 N/A N/A
K704 Paediatric out_patient case conference (per unit) $31.35 N/A N/A
K701 Mental health out_patient case conference (per unit) $31.35 N/A N/A
K702 Bariatric out_patient case conference (per unit) $31.35 N/A N/A
K703 Geriatric out_patient case (per unit) $31.35 N/A N/A
K707 Chronic pain out_patient case conference (per unit) $31.35 N/A N/A
K124 Long_term care/CCAC case (per unit) $31.35 N/A N/A
K705 Long_term care _ high risk patient conference (per unit) $31.35 N/A N/A
K706 Convalescent care program case conference $31.35 N/A N/A
K734 Physician to physician telephone consultation _ Referring physician (Physician on duty in an emergency department or a hospital urgent care clinic) $31.35 N/A N/A
K735 Physician to physician telephone consultation _ Consultant physician (Physician on duty in an emergency department or a hospital urgent care clinic) $40.45 N/A N/A
K733 CritiCall telephone consultation _ Consultant physician $40.45 N/A N/A
K736 CritiCall telephone consultation _ Referring physician (Physician on duty in an emergency department or a hospital urgent care clinic) $31.35 N/A N/A
K737 CritiCall telephone consultation _ Consultant physician (Physician on duty in an emergency department or a hospital urgent care clinic) $40.45 N/A N/A
K739 Physician to physician e_consultation _ Consultant physician $20.50 N/A N/A
K022 HIV primary care (per unit) $62.75 N/A N/A
K037 Fibromyalgia/chronic fatigue syndrome care (per unit) $62.75 N/A N/A
K023 Palliative care support (per unit) $62.75 N/A N/A
K106 Genetic assessment $74.05 N/A N/A
K028 STD management $62.75 N/A N/A
K029 Insulin therapy support (ITS) $62.75 N/A N/A
K030 Diabetic Management Assessment $39.20 N/A N/A
Q040 Diabetes management incentive $60.00 N/A N/A
K090 Pre_operative medical management of a bariatric surgery patient in a Bariatric RATC $100.00 N/A N/A
K091 Post_operative monthly management of a bariatric surgery patient in a Bariatric RATC $25.00 N/A N/A
E079 - Initial discussion with patient, to eligible services $15.40 N/A N/A
K039 Smoking cessation follow-up visit $33.45 N/A N/A
K018 Sexual assault examination - female $308.70 N/A N/A
K021 Sexual assault examination - male $243.50 N/A N/A
K026 Certification of Medical Eligibility for OHCAP $54.70 N/A N/A
K027 Certification of Medical Eligibility for OHCAP _ includes only completion of Application for OHCAP _ Physician's Form without an associated consultation or visit on the same day. $21.85 N/A N/A
K031 Completion of Form 1 _ Physician report in accordance with the Mandatory Blood Testing Act $102.50 N/A N/A
K071 Acute home care supervision (first 8 weeks following admission to the home care program) $21.40 N/A N/A
K072 Chronic home care supervision (after the 8th week following admission to the home care program) $21.40 N/A N/A
K036 Completion of northern health travel grant application form $10.25 N/A N/A
K034 Telephone reporting _ specified reportable disease to a MOH $36.00 N/A N/A
K399 Clinical interpretation by an immunologist $29.05 N/A N/A
A680 Initial assessment _ substance abuse $144.75 N/A N/A
C680 Initial assessment _ substance abuse _ subject to the same conditions as A680 $144.75 N/A N/A
K680 Substance abuse _ extended assessment (per unit) $62.75 N/A N/A