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Billing code

A075A — Geriatric consultation

Geriatric consultation

A geriatrician bills A075 for a consultation in the office or another general setting at a physician's or nurse practitioner's written request.

Watch for: Put the referrer's billing number on the claim; for in-patient, long-term care or emergency special visits, bill A070 instead.

Code

A075A

Description

Geriatric consultation

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Consultation by a geriatrician in the office or another general setting, at the written request of a physician or nurse practitioner.

What it covers

A075 is the Geriatrics (07) consultation under the General Listings (A118). A consultation is an assessment done at the written request of a physician, nurse practitioner (or a dental surgeon for hospital dental work) who wants your opinion because the case is complex, serious or obscure, or because the patient asked for another opinion. It includes a general, specific or medical specific assessment, a review of relevant data and a written report to the referrer (GP16).

For a consultation that needs a special visit to a hospital in-patient, LTC resident or ED patient, bill A070 with the matching special visit premium instead (A118).

Billing rules

• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Geriatrics (07) (GP9).
• Needs a written, signed request from a physician or nurse practitioner that names you or your specialty, the referrer and their billing number, and the patient and health number. Without it, OHIP pays a lesser assessment (GP16).
• Same patient, same consultant, same diagnosis: one consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first; a clearly unrelated diagnosis allows one every 12 months. Extra consultations pay as an assessment (GP17–GP18).
• A referral you ask for after seeing the patient does not make the visit a consultation; bill the visit you actually provided (GP16).
• Send a written report with your findings, opinion and recommendations to the referrer, and also to the primary care provider when a nurse practitioner referred (GP16).
• Detention (K001) can be added only after 60 minutes of consultation time (GP30–GP31).
• Can be done by video only, not phone, with modality indicator K300A. A video consultation listed in Appendix J itself creates the patient relationship needed for virtual care (AJ2, A66, A70).

Often billed with

• K001 detention, after the first 60 minutes (GP30–GP31).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
• EQ6: OHIP describes this as 'Referring provider number not registered with the Ministry': check the referrer's billing number against the written request and resubmit (GP16).
• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: A775, A770, A375, A076, A070, C075, W075, A073

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A118. Consultation rules GP16–GP19.

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