OHIP Billing Codes

Specialty: Family Practice Practice In General 00

Code	Description	Fee
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A001	Minor assessment	24.25
A002	Enhanced 18 month well baby visit	63.45
A003	General assessment	86.15
A004	General re-assessment	39.1
A005	Consultation	86.15
A006	Repeat consultation	46.8
A007	Intermediate assessment or well baby care	37.6
A008	Mini assessment	13.3
A100	General/Family physician emergency department assessment	78.45
A110	Periodic oculo-visual assessment - aged 19 years and below	49.9
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A112	Periodic oculo-visual assessment - aged 65 years and above	49.9
	E078 - chronic disease assessment premium (see General Preamble GP116) - add 50%
A115	Major eye examination	52.15
A680	Initial assessment - substance abuse	147.65
A771	Certification of death	21
A777	Intermediate assessment Pronouncement of death	37.6
A813	Midwife-RequestedAssessment (MRA)	113.95
A815	Midwife-Requested Special Assessment (MRSA)	190.7
A816	Midwife-RequestedAnaesthesia Assessment (MRAA)	108.95
A888	Emergency department equivalent - partial assessment	37.6
A900	Complex house call assessment	46.05
A902	House call assessment - Pronouncement of death in the home	46.05
A905	Limited consultation	73.55
A911	Special family and general practice consultation	147.65
A912	Comprehensive family and general practice consultation	221.5
A933	On-call admission assessment	81.5
A945	Special palliative care consultation	162.4
C002	Subsequent visits - First 5 Weeks - per visit	34.8
C003	General assessment	86.15
C004	General re-assessment	39.1
C005	Consultation	86.15
C006	Repeat consultation	46.8
C007	Subsequent visits - sixth to thirteenth week inclusive (maximum 3 per patient per week) - per visit	31.6
C008	Subsequent visits by the MRP following transfer from an Intensive Care Area - Concurrent care - per visit	31.6
C009	Subsequent visits - after thirteenth week (maximum 6 per patient per month) - per visit	31.6
C010	Subsequent visits by the MRP following transfer from an Intensive Care Area - Supportive care - per visit	19.25
C121	Additional visits due to intercurrent illness (see General Preamble GP43) - per visit	31.6
C122	Subsequent visits by the Most Responsible Physician (MRP) - day following the hospital admission assessment	62.4
C123	Subsequent visits by the Most Responsible Physician (MRP) - second day following the hospital assessment	62.4
C124	Subsequent visits by the Most Responsible Physician (MRP) - day of discharge	62.4
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	62.4
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	62.4
C680	Initial assessment - substance abuse - subject to the same conditions as A680	147.65
C771	Certification of death - subject to the same conditions as A771	21
C777	Intermediate assessment - Pronouncement of death - subject to the same conditions as A777	37.6
C813	Midwife-Requested Assessment - subject to the same conditions as A813	113.95
C815	Midwife-Requested Special Assessment - subject to the same conditions as A815	190.7
C816	Midwife-Requested Anaesthesiologist Assessment (MRAA) - subject to the same conditions as A816	108.95
C882	Subsequent visits by the MRP following transfer from an Intensive Care Area - Palliative care (see General Preamble GP34) - per visit	31.6
C903	Pre-dental/pre-operative general assessment (maximum of 2 per 12 month period)	66.35
C904	Pre-dental/pre-operative assessment	34.4
C905	Limited consultation	73.55
C911	Special family and general practice consultation, subject to the same conditions as A911	147.65
C912	Comprehensive family and general practice consultation subject to the same conditions as A912	221.5
C933	On-call admission assessment - subject to the same conditions as A933	81.5
C945	Special palliative care consultation - subject to the same conditions as A945	162.4
E077	Identification of patient for a major eye examination	10.45
E079	Initial discussion with patient, to eligible services	15.85
H001	Newborn care in hospital and/or home	53.25
H002	Low birth weight baby care (uncomplicated) - initial visit (per baby)	33.4
H003	Low birth weight baby care (uncomplicated) - subsequent visit - per visit	16.6
H007	Attendance at maternal delivery for care of high risk baby(ies)	62.9
H065	Consultation in Emergency Medicine	82.9
H100	Emergency department investigative ultrasound	20.05
H101	Minor assessment - Monday to Friday - Daytime (08:00h to 17:00h)	16.9
H102	Comprehensive assessment and care - Monday to Friday - Daytime (08:00h to 17:00h)	42.5
H103	Multiple systems assessment - Monday to Friday - Daytime (08:00h to 17:00h)	40.15
H105	In-patient interim admission orders	26.8
H112	Other service rendered by Emergency Department Physician in premium hours - nights (00:00h to 08:00h)	35.85
H113	Other service rendered by Emergency Department Physician in premium hours - daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays	20.75
H121	Minor assessment - Nights (00:00h to 08:00h)	31.2
H122	Comprehensive assessment and care - Nights (00:00h to 08:00h)	78.25
H123	Multiple systems assessment - Nights (00:00h to 08:00h)	69.1
H124	Re-assessment - Nights (00:00h to 08:00h)	31.2
H131	Minor assessment - Monday to Friday - Evenings (17:00h to 24:00h)	21.05
H132	Comprehensive assessment and care - Monday to Friday - Evenings (17:00h to 24:00h)	52.9
H133	Multiple systems assessment - Monday to Friday - Evenings (17:00h to 24:00h)	47.75
H134	Re-assessment - Monday to Friday - Evenings (17:00h to 24:00h)	21.05
H151	Minor assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h)	26.75
H152	Comprehensive assessment and care - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h)	67
H153	Multiple systems assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h)	59.7
H154	Re-assessment - Saturdays, Sundays and Holidays - Daytime and Evenings (08:00h to 24:00h)	26.75
K002	Family meeting, caregiver interview	69.1
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)	69.1
K004	Psychotherapy - Family (2 or more family members in attendance at the same time) per unit	75.05
K005	Primary mental health care - Individual care	69.1
K006	Hypnotherapy - Individual care	69.1
K007	Psychotherapy - Individual care	69.1
K008	Diagnostic interview and/or counselling with child and/or parent for psychological problem or learning disabilities (per unit)	69.1
K010	Psychotherapy - additional units per member (maximum 6 units per patient per day)	11
K012	Psychotherapy - Group 3 people (per unit)	17.4
K014	Counselling for transplant recipients, donors or families of recipients and donors	69.1
K015	Counselling of relatives - on behalf of catastrophically or terminally ill patient	69.1
K016	Genetic assessment, patient or family - per unit	75.55
K017	Periodic health visit - child	44.5
K018	Sexual assault examination - female	326
K019	Psychotherapy - Group 2 people (per unit)	34.6
K020	Psychotherapy - Group 3 people (per unit)	23
K021	Sexual assault examination - male	257.15
K022	HIV primary care (per unit)	69.1
K023	Palliative care support (per unit)	73.6
K024	Psychotherapy - Group 5 people (per unit)	14.35
K025	Psychotherapy - Group 6 to 12 people (per unit)	12.2
K026	Certification of Medical Eligibility for OHCAP	55.8
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.	22.3
K028	STD management	69.1
K029	Insulin therapy support (ITS)	69.1
K030	Diabetic Management Assessment	41.35
K031	Completion of Form 1 - Physician report in accordance with the Mandatory Blood Testing Act	104.55
K032	Specific neurocognitive assessment	69.1
K034	Telephone reporting - specified reportable disease to a MOH	36.7
K035	Mandatory reporting of medical condition to the Ontario Ministry of Transportation	37
K036	Completion of northern health travel grant application form	10.45
K037	Fibromyalgia/chronic fatigue syndrome care (per unit)	69.1
K038	Completion of Long-Term Care health report form	46.05
K039	Smoking cessation follow-up visit	34.1
K070	Home care application	32.4
K071	Acute home care supervision (first 8 weeks following admission to the home care program)	21.85
K072	Chronic home care supervision (after the 8th week following admission to the home care program)	21.85
K090	Pre-operative medical management of a bariatric surgery patient in a Bariatric RATC	102
K091	Post-operative monthly management of a bariatric surgery patient in a Bariatric RATC	25.5
K121	Hospital in-patient case conference	32
K124	Long-term care/CCAC case (per unit)	32
K130	Periodic health visit - adolescent	78.75
K131	Periodic health visit - adult age 18 to 64 inclusive	55.1
K132	Periodic health visit - adult 65 years of age and older	78.75
K140	Chronic disease shared appointment - 2 patients (per unit)	34.6
K141	Chronic disease shared appointment - 3 patients (per unit)	23
K142	Chronic disease shared appointment - 4 patients (per unit)	17.4
K143	Chronic disease shared appointment - 5 patients (per unit)	14.35
K144	Chronic disease shared appointment - 6 to 12 patients (per unit)	12.2
K399	Clinical interpretation by an immunologist	29.65
K623	Application for psychiatric assessment	115.65
K624	Certification of involuntary admission	142.4
K629	All other re-certification(s) of involuntary admission including completion of appropriate forms	42.2
K680	Substance abuse - extended assessment (per unit)	69.1
K682	Opioid Agonist Maintenance Program monthly management fee - intensive, per month	45.9
	K684 - opioid Agonist Maintenance Program - team premium, per month - add	6.1
K683	Opioid Agonist Maintenance Program monthly management fee - maintenance, per month	38.75
	K684 - opioid Agonist Maintenance Program - team premium, per month - add	6.1
K700	Palliative care out-patient case conference (per unit)	32
K701	Mental health out-patient case conference (per unit)	32
K702	Bariatric out-patient case conference (per unit)	32
K703	Geriatric out-patient case (per unit)	32
K704	Paediatric out-patient case conference (per unit)	32
K705	Long-term care - high risk patient conference (per unit)	32
K706	Convalescent care program case conference	32
K707	Chronic pain out-patient case conference (per unit)	32
K708	MCC Participant, per patient	32
K709	MCC Chairperson, per patient	41.25
K710	MCC Radiologist Participant, per patient	32
K730	Physician to physician telephone consultation - Referring physician	32
K731	Physician to physician telephone consultation - Consultant physician	41.25
K732	CritiCall telephone consultation - Referring physician	32
K733	CritiCall telephone consultation - Consultant physician	41.25
K734	Physician to physician telephone consultation - Referring physician (Physician on duty in an emergency department or a hospital urgent care clinic)	32
K735	Physician to physician telephone consultation - Consultant physician (Physician on duty in an emergency department or a hospital urgent care clinic)	41.25
K736	CritiCall telephone consultation - Referring physician (Physician on duty in an emergency department or a hospital urgent care clinic)	32
K737	CritiCall telephone consultation - Consultant physician (Physician on duty in an emergency department or a hospital urgent care clinic)	41.25
K738	Physician to physician e-consultation Referring physician	16.3
K739	Physician to physician e-consultation - Consultant physician	20.9
K887	CTO initiation including completion of the CTO form and all preceding CTO services directly related to CTO initiation (per unit)	93.45
K888	CTO supervision including all associated CTO services except those related to initiation or renewal (per unit)	93.45
K889	CTO renewal including completion of the CTO form and all preceding CTO services directly related to CTO renewal (per unit)	93.45
Q040	Diabetes management incentive	61.2
W001	Chronic care or convalescent hospital - additional subsequent visits (maximum 4 per patient per month) per visit	21.65
W002	Chronic care or convalescent hospital - first 4 subsequent visits per patient per month (per visit)	32.85
W003	Nursing home or home for the aged - first 2 subsequent visits per patient per month (per visit)	32.85
W004	General re-assessment of patient in nursing home (per the Nursing Homes Act)	39.1
W008	Nursing home or home for the aged - additional subsequent visits (maximum 2 per patient per month) per visit	21.65
W010	Monthly management fee (per patient per month) (see General Preamble GP51 to GP52)	111.05
W102	Admission assessment - Type 1	70.75
W104	Admission assessment - Type 2	21
W105	Consultation - Long-Term Care In-Patient	78.75
W106	Repeat consultation	46.8
W107	Admission assessment - Type 3	31.3
W109	Periodic health visit	71.9
W121	additional visits due to intercurrent illness (see General Preamble GP49) per visit	31.6
W771	Certification of death - subject to same conditions as A771	21
W777	Intermediate assessment - Pronouncement of death - subject to the same conditions as A777	37.6
W872	Nursing home or home for the aged - palliative care (see General Preamble GP50) per visit	32.85
W882	Chronic care or convalescent hospital - palliative care (see General Preamble GP50) per visit	32.85
W903	Pre-dental/pre-operative general assessment (maximum of 2 per 12 month period)	66.35
W904	Pre-dental/pre-operative assessment	34.4
W911	Special family and general practice consultation - subject to the same conditions as A911	147.65
W912	Comprehensive family and general practice consultation - subject to the same conditions as A912	221.5

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