Billing code
A130A — Comprehensive Internal Medicine Consultation
Long internal medicine consultation
An internist bills A130 for a full consultation with at least 75 minutes of direct patient contact.
Watch for: Record start and stop times in the chart, or OHIP pays a lesser fee; put the referrer's billing number on the claim.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $342.25 | $0.00 | $0.00 | $0.00 |
- Code
- A130A
- Description
- Comprehensive Internal Medicine 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
Internal medicine consultation with at least 75 minutes of direct patient contact, meeting all the elements of a consultation.
What it covers
A comprehensive internal medicine consultation is a consultation by a specialist in internal medicine who provides all the appropriate elements of a consultation and spends at least 75 minutes in direct contact with the patient (A129).
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).
Billing rules
- Must be rendered by a specialist in internal medicine (A129).
- At least 75 minutes of direct patient contact, excluding other separately paid services and non-patient-facing work such as chart, imaging or documentation review (A129).
- Record start and stop times in the patient's permanent medical record, or OHIP pays a lesser fee (A129).
- Must meet all the elements of a consultation, including the written request and written report (A129, GP16).
- Counts toward the general consultation limits for the same patient and diagnosis (GP17–GP18).
- Detention (K001) can be added only after 120 minutes (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 120 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).
- 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: A135, C130, W130, A435, A136, A133
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A129. Consultation rules GP16–GP18.
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