Infectious disease OHIP billing codes

These are the most commonly used Infectious disease OHIP billing codes. To find other billing codes search the OHIP fee schedule here .


General Listings

Code Description Amount
A465 Consultation $157.00
A460 Comprehensive infectious disease consultation $300.70
A275 Limited consultation $105.25
A466 Repeat consultation $105.25
A463 Medical specific assessment $79.85
A464 Medical specific re-assessment $61.25
A461 Complex medical specific re-assessment $70.90
A468 Partial assessment $38.05
E078 - chronic disease assessment premium (see General Preamble GP16) … add 50% $0.00

Non Emergency Hospital In Patient Services

Code Description Amount
C465 Consultation $157.00
C460 Comprehensive infectious disease consultation - subject to the same conditions as A460 $300.70
C275 Limited consultation $105.25
C466 Repeat consultation $105.25
C463 Medical specific assessment $79.85
C464 Medical specific re-assessment $61.25
C461 Complex medical specific re-assessment $70.90
C462 Subsequent visits - first five weeks … per visit $31.00
C467 Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) … per visit $31.00
C469 Subsequent visits - after thirteenth week (maximum 6 per patient per month) … per visit $31.00
C468 Concurrent care … per visit $31.00

Non Emergency Long Term Care In Patient Services

Code Description Amount
W465 Consultation $157.00
W460 Comprehensive infectious disease consultation - subject to the same conditions as A460 $300.70
W275 Limited consultation $105.25
W466 Repeat consultation $105.25
W292 Admission assessment - Type 1 $69.35
W294 Admission assessment - Type 2 $20.60
W297 Admission assessment - Type 3 $30.70
W299 Periodic health visit $65.05
W464 General re-assessment of patient in nursing home (as per the Nursing Homes Act)* $20.60
W462 Subsequent visits - Chronic care or convalescent hospital - first 4 subsequent visits per patient per month … per visit $32.20
W461 Subsequent visits - Chronic care or convalescent hospital - additional subsequent visits (maximum of 6 per patient per month) … per visit $21.20
W463 Subsequent visits - Nursing home or home for the aged - first 2 subsequent visits per patient per month … per visit $32.20
W468 Subsequent visits - Nursing home or home for the aged - subsequent visits per month (maximum of 3 per patient per month) … per visit $21.20

Other

Code Description Amount
A765 Consultation, patient 16 years of age and under $165.50
C765 Consultation, patient 16 years of age and under $165.50
C122 Subsequent visits by the Most Responsible Physician (MRP) - day following the hospital admission assessment $58.80
E083 - Subsequent visit by the MRP Premium $0.00
C123 Subsequent visits by the Most Responsible Physician (MRP) - second day following the hospital assessment $58.80
E083 - Subsequent visit by the MRP Premium $0.00
C124 Subsequent visits by the Most Responsible Physician (MRP) - day of discharge $58.80
E083 - Subsequent visit by the MRP Premium $0.00
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
E083 - Subsequent visit by the MRP Premium $0.00
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
E083 - Subsequent visit by the MRP Premium $0.00
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
C982 Palliative care $31.00
E083 - Subsequent visit by the MRP Premium $0.00
W765 Consultation, patient 16 years of age and under $167.00
W982 Subsequent visits - Chronic care or convalescent hospital - palliative care $32.20
W972 Subsequent visits - Nursing home or home for the aged - palliative care $32.20
W121 Additional visits due to intercurrent illness (see General Preamble GP33) per visit $31.00