Paediatrics OHIP billing codes

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


General Listings

Code Description Amount
A265 Consultation $167.00
A260 Special paediatric consultaton $300.70
A662 Extended special paediatric consultation $395.65
A667 Neurodevelopmental consultation $395.65
A665 Prenatal consultation $91.35
A565 Limited consultation $91.35
A266 Repeat consultation $91.35
A263 Medical specific assessment $77.70
A264 Medical specific re-assessment $59.45
A661 Complex medical specific re-assessment $68.80
A268 Enhanced 18 month well baby visit (see General Preamble GP22) $62.40
A261 Level 1 - Paediatric assessment $21.50
A262 Level 2 - Paediatric assessment $42.15
E078 - chronic disease assessment premium (see General Preamble GP16) … add 50% $0.00
K267 Periodic health visit - 2 - 11 years of age $41.60
K269 Periodic health visit - 12 - 17 years of age $77.20
K119 Paediatric developmental assessment incentive $100.00
K122 Developmental and/or behavioural care - individual developmental and/or behavioural care … per unit $80.30
K123 Developmental and/or behavioural care - family developmental and/or behavioural care … per unit $91.10

Non Emergency Hospital In Patient Services

Code Description Amount
C265 Consultation $167.00
C260 Special paediatric consultation - subject to the same conditions as A260 $300.70
C662 Extended special paediatric consultation - subject to the same conditions as A662 $395.65
C667 Neurodevelopmental consultation - subject to same conditions as A667 $395.65
C665 Prenatal consultation - subject to the same conditions as A665 $91.35
C565 Limited consultation $91.35
C266 Repeat consultation $91.35
C263 Medical specific assessment $77.70
C264 Medical specific re-assessment $59.45
C661 Complex medical specific re-assessment $68.80
C262 Subsequent visits - first five weeks … per visit $31.00
C267 Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) … per visit $31.00
C269 Subsequent visits - after thirteenth week (maximum 6 per patient per month) … per visit $31.00
C268 Concurrent care … per visit $31.00
H267 Attendance at maternal delivery $63.45
H261 Newborn care in hospital or home $57.90
H262 Low birth weight newborn uncomplicated care - initial … per newborn $61.00
H263 Low birth weight newborn uncomplicated care - thereafter … per visit $17.75

Non Emergency Long Term Care In Patient Services

Code Description Amount
W265 Consultation $167.00
W260 Special paediatric consultation - subject to the same conditions as A260 $300.70
W662 Extended special paediatric consultation - subject to the same conditions as A662 $395.65
W667 Neurodevelopmental consultation - subject to same conditions as A667 $395.65
W565 Limited consultation $91.35
W266 Repeat consultation $82.90
W562 Admission assessment - Type 1 $69.35
W564 Admission assessment - Type 2 $20.60
W567 Admission assessment - Type 3 $30.70
W269 Periodic health visit $30.70
W262 Subsequent visits - Chronic care or convalescent hospital - first 4 subsequent visits per patient per month … per visit $32.20
W261 Subsequent visits - Chronic care or convalescent hospital - additional subsequent visits (maximum 6 per patient per month) … per visit $21.20

Other

Code Description Amount
K045 Diabetes management by a specialist $75.00
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
W982 Subsequent visits - Chronic care or convalescent hospital - palliative care $32.20