Physical medicine & rehabilitation OHIP billing codes


General Listings

Code Description Amount Ans Units Assist Units
A315 Consultation $172.85 N/A N/A
A425 Comprehensive physical medicine and rehabilitation consultation $300.70 N/A N/A
A515 Limited consultation $91.35 N/A N/A
A316 Repeat consultation $91.35 N/A N/A
A313 Medical specific assessment $74.00 N/A N/A
A310 Medical specific re-assessment $65.00 N/A N/A
A311 Complex medical specific re-assessment $70.90 N/A N/A
A318 Partial assessment $38.05 N/A N/A
E078 - chronic disease assessment premium (see General Preamble GP16) … add 50% $0.00 N/A N/A
A510 Complex neuromuscular assessment $89.85 N/A N/A
A511 Complex physiatry assessment $89.85 N/A N/A

Non Emergency Hospital In Patient Services

Code Description Amount Ans Units Assist Units
C315 Consultation $182.85 N/A N/A
C425 Comprehensive physical medicine and rehabilitation consultation – subject to the same conditions as A425 $300.70 N/A N/A
C515 Limited consultation $91.35 N/A N/A
C316 Repeat consultation $91.35 N/A N/A
C313 Medical specific assessment $74.00 N/A N/A
C314 Medical specific re-assessment $65.00 N/A N/A
C311 Complex medical specific re-assessment $70.90 N/A N/A
C510 Complex neuromuscular assessment - subject to the same conditions as A510 $89.85 N/A N/A
C511 Complex physiatry assessment - subject to the same conditions as A511 $89.85 N/A N/A
C312 Subsequent visits - first five weeks … per visit $31.00 N/A N/A
C317 Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) … per visit $31.00 N/A N/A
C319 Subsequent visits - after thirteenth week (maximum 6 per patient per month) … per visit $31.00 N/A N/A
C318 Concurrent care … per visit $31.00 N/A N/A

Non Emergency Long Term Care In Patient Services

Code Description Amount Ans Units Assist Units
W515 Consultation $182.85 N/A N/A
W425 Comprehensive physical medicine and rehabilitation consultation - subject to the same conditions as A425 $300.70 N/A N/A
W310 Limited consultation $91.35 N/A N/A
W516 Repeat consultation $91.35 N/A N/A
W510 Complex neuromuscular assessment - subject to the same conditions as A510 $89.85 N/A N/A
W511 Complex physiatry assessment - subject to the same conditions as A511 $89.85 N/A N/A
W512 Admissing assessment - Type 1 $69.35 N/A N/A
W514 Admissing assessment - Type 2 $20.60 N/A N/A
W517 Admissing assessment - Type 3 $30.70 N/A N/A
W419 Periodic health visit $65.05 N/A N/A
W314 General reassessment of patient in nursing home* $20.60 N/A N/A
W312 Subsequent visits - Chronic care or convalescent hospital - first 4 subsequent visits per patient per month … per visit $32.20 N/A N/A
W311 Subsequent visits - Chronic care or convalescent hospital - additional subsequent visits (maximum 6 per patient per month) … per visit $21.20 N/A N/A
W313 Subsequent visits - Nursing home or home for the aged - first 2 subsequent visits per patient per month … per visit $32.20 N/A N/A
W318 Subsequent visits - Nursing home or home for the aged - additional subsequent visits (maximum 3 per patient per month) … per visit $21.20 N/A N/A
H312 Team management in a Rehabilitation Unit - first twelve weeks … per visit $39.00 N/A N/A
H317 Team management in a Rehabilitation Unit - from thirteenth to twentysixth week (maximum 3 per patient per week) … per visit $39.00 N/A N/A
H319 Team management in a Rehabilitation Unit - twentyseventh week onwards (maximum 6 per patient per month) … per visit $39.00 N/A N/A
H313 Rehabilitation counselling $76.95 N/A N/A
K313 Physiatric management $8.10 N/A N/A

Other

Code Description Amount Ans Units Assist Units
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
W972 Subsequent visits - 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