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