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 reassessment $39.10
A005 Consultation $86.15
A006 Repeat consultation $46.80
A007 Intermediate assessment or well baby care $37.60
A008 Mini assessment $13.30
A100 General/Family physician emergency department assessment $78.45
A110 Periodic oculovisual assessment aged 19 years and below $49.90

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A112 Periodic oculovisual assessment aged 65 years and above $49.90
A115 Major eye examination $52.15
A680 Initial assessment substance abuse $147.65
A771 Certification of death $21.00
A777 Intermediate assessment Pronouncement of death $37.60
A813 MidwifeRequestedAssessment (MRA) $113.95
A815 MidwifeRequested Special Assessment (MRSA) $190.70
A816 MidwifeRequestedAnaesthesia Assessment (MRAA) $108.95
A888 Emergency department equivalent partial assessment $37.60
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 $221.50
A933 Oncall admission assessment $81.50
A945 Special palliative care consultation $162.40
C002 Subsequent visits First 5 Weeks per visit $34.80
C003 General assessment $86.15
C004 General reassessment $39.10
C005 Consultation $86.15
C006 Repeat consultation $46.80
C007 Subsequent visits sixth to thirteenth week inclusive (maximum 3 per patient per week) per visit $31.60
C008 Subsequent visits by the MRP following transfer from an Intensive Care Area Concurrent care per visit $31.60
C009 Subsequent visits after thirteenth week (maximum 6 per patient per month) per visit $31.60
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 $31.60
C122 Subsequent visits by the Most Responsible Physician (MRP) day following the hospital admission assessment $62.40
C123 Subsequent visits by the Most Responsible Physician (MRP) second day following the hospital assessment $62.40
C124 Subsequent visits by the Most Responsible Physician (MRP) day of discharge $62.40
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 $62.40
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 $62.40
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 $21.00
C777 Intermediate assessment Pronouncement of death subject to the same conditions as A777 $37.60
C813 MidwifeRequested Assessment subject to the same conditions as A813 $113.95
C815 MidwifeRequested Special Assessment subject to the same conditions as A815 $190.70
C816 MidwifeRequested 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 $31.60
C903 Predental/preoperative general assessment (maximum of 2 per 12 month period) $66.35
C904 Predental/preoperative assessment $34.40
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 $221.50
C933 Oncall admission assessment subject to the same conditions as A933 $81.50
C945 Special palliative care consultation subject to the same conditions as A945 $162.40
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) $33.40
H003 Low birth weight baby care (uncomplicated) subsequent visit per visit $16.60
H007 Attendance at maternal delivery for care of high risk baby(ies) $62.90
H065 Consultation in Emergency Medicine $82.90
H100 Emergency department investigative ultrasound $20.05
H101 Minor assessment Monday to Friday Daytime (08:00h to 17:00h) $16.90
H102 Comprehensive assessment and care Monday to Friday Daytime (08:00h to 17:00h) $42.50
H103 Multiple systems assessment Monday to Friday Daytime (08:00h to 17:00h) $40.15
H105 Inpatient interim admission orders $26.80
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) $31.20
H122 Comprehensive assessment and care Nights (00:00h to 08:00h) $78.25
H123 Multiple systems assessment Nights (00:00h to 08:00h) $69.10
H124 Reassessment Nights (00:00h to 08:00h) $31.20
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) $52.90
H133 Multiple systems assessment Monday to Friday Evenings (17:00h to 24:00h) $47.75
H134 Reassessment 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) $67.00
H153 Multiple systems assessment Saturdays, Sundays and Holidays Daytime and Evenings (08:00h to 24:00h) $59.70
H154 Reassessment Saturdays, Sundays and Holidays Daytime and Evenings (08:00h to 24:00h) $26.75
K002 Family meeting, caregiver interview $69.10
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) $69.10
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 $69.10
K006 Hypnotherapy Individual care $69.10
K007 Psychotherapy Individual care $69.10
K008 Diagnostic interview and/or counselling with child and/or parent for psychological problem or learning disabilities (per unit) $69.10
K010 Psychotherapy additional units per member (maximum 6 units per patient per day) $11.00
K012 Psychotherapy Group 3 people (per unit) $17.40
K014 Counselling for transplant recipients, donors or families of recipients and donors $69.10
K015 Counselling of relatives on behalf of catastrophically or terminally ill patient $69.10
K016 Genetic assessment, patient or family per unit $75.55
K017 Periodic health visit child $44.50
K018 Sexual assault examination female $326.00
K019 Psychotherapy Group 2 people (per unit) $34.60
K020 Psychotherapy Group 3 people (per unit) $23.00
K021 Sexual assault examination male $257.15
K022 HIV primary care (per unit) $69.10
K023 Palliative care support (per unit) $73.60
K024 Psychotherapy Group 5 people (per unit) $14.35
K025 Psychotherapy Group 6 to 12 people (per unit) $12.20
K026 Certification of Medical Eligibility for OHCAP $55.80
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. $22.30
K028 STD management $69.10
K029 Insulin therapy support (ITS) $69.10
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 $69.10
K034 Telephone reporting specified reportable disease to a MOH $36.70
K035 Mandatory reporting of medical condition to the Ontario Ministry of Transportation $37.00
K036 Completion of northern health travel grant application form $10.45
K037 Fibromyalgia/chronic fatigue syndrome care (per unit) $69.10
K038 Completion of LongTerm Care health report form $46.05
K039 Smoking cessation followup visit $34.10
K070 Home care application $32.40
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 Preoperative medical management of a bariatric surgery patient in a Bariatric RATC $102.00
K091 Postoperative monthly management of a bariatric surgery patient in a Bariatric RATC $25.50
K121 Hospital inpatient case conference $32.00
K124 Longterm care/CCAC case (per unit) $32.00
K130 Periodic health visit adolescent $78.75
K131 Periodic health visit adult age 18 to 64 inclusive $55.10
K132 Periodic health visit adult 65 years of age and older $78.75
K140 Chronic disease shared appointment 2 patients (per unit) $34.60
K141 Chronic disease shared appointment 3 patients (per unit) $23.00
K143 Chronic disease shared appointment 5 patients (per unit) $14.35
K144 Chronic disease shared appointment 6 to 12 patients (per unit) $12.20
K399 Clinical interpretation by an immunologist $29.65
K623 Application for psychiatric assessment $115.65
K624 Certification of involuntary admission $142.40
K629 All other recertification(s) of involuntary admission including completion of appropriate forms $42.20
K680 Substance abuse extended assessment (per unit) $69.10
K682 Opioid Agonist Maintenance Program monthly management fee intensive, per month $45.90
K683 Opioid Agonist Maintenance Program monthly management fee maintenance, per month $38.75
K700 Palliative care outpatient case conference (per unit) $32.00
K701 Mental health outpatient case conference (per unit) $32.00
K702 Bariatric outpatient case conference (per unit) $32.00
K703 Geriatric outpatient case (per unit) $32.00
K704 Paediatric outpatient case conference (per unit) $32.00
K705 Longterm care high risk patient conference (per unit) $32.00
K706 Convalescent care program case conference $32.00
K707 Chronic pain outpatient case conference (per unit) $32.00
K708 MCC Participant, per patient $32.00
K709 MCC Chairperson, per patient $41.25
K710 MCC Radiologist Participant, per patient $32.00
K730 Physician to physician telephone consultation Referring physician $32.00
K731 Physician to physician telephone consultation Consultant physician $41.25
K732 CritiCall telephone consultation Referring physician $32.00
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) $32.00
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) $32.00
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 econsultation Referring physician $16.30
K739 Physician to physician econsultation Consultant physician $20.90
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 $61.20
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 reassessment of patient in nursing home (per the Nursing Homes Act) $39.10
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 $21.00
W105 Consultation LongTerm Care InPatient $78.75
W106 Repeat consultation $46.80
W107 Admission assessment Type 3 $31.30
W109 Periodic health visit $71.90
W121 additional visits due to intercurrent illness (see General Preamble GP49) per visit $31.60
W771 Certification of death subject to same conditions as A771 $21.00
W777 Intermediate assessment Pronouncement of death subject to the same conditions as A777 $37.60
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 Predental/preoperative general assessment (maximum of 2 per 12 month period) $66.35
W904 Predental/preoperative assessment $34.40
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 $221.50

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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