OHIP Billing Codes

Specialty: Family Practice Practice In General 00

Code Description Fee
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
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
K683 Opioid Agonist Maintenance Program monthly management fee - maintenance, per month 38.75
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

The information presented on this page is general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBCx or its affiliates.

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