Paediatrics OHIP billing codes


General Listings

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

Non Emergency Hospital In Patient Services

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

Non Emergency Long Term Care In Patient Services

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

Other

Code Description Amount Ans Units Assist Units
K045 Diabetes management by a specialist $75.00 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
C982 Palliative care (see General Preamble GP34) … per visit $31.00 N/A N/A
W982 Subsequent visits - Chronic care or convalescent hospital - palliative care (see General Preamble GP34) … per visit $32.20 N/A N/A