What are the billing rules for A190A?

Start and stop times must be in the chart, or the service is not payable (A183). All consultation requirements apply: a written, signed request naming the referrer and billing number, kept in the chart, and a written report back. Otherwise it is paid as a lesser assessment (GP16). The consultation limits apply to special consultations: same diagnosis, one per two consecutive 12-month periods; unrelated diagnosis, one per 12 months (GP17, GP18).

What is A190A often billed with?

K300A when the consultation is done by video (A70, AJ2). K630 psychiatric consultation extension, maximum six units per patient per physician per day (A185).

Why is A190A rejected?

EH2: The health card version code on the claim doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit.

< Billing codes

Billing code

A190A — Special Psychiatric Consultation

Q: What is OHIP billing code A190A?

Special psychiatric consultation: a full psychiatric consultation with at least 75 minutes of direct contact. Start and stop times required.

Long psychiatric consultation

A psychiatrist bills A190 for a full psychiatric consultation with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the chart, or the service is not payable; it also needs a signed written referral.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$342.25	$0.00	$0.00	$0.00

Code: A190A
Description: Special Psychiatric 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

Special psychiatric consultation: a full psychiatric consultation with at least 75 minutes of direct contact. Start and stop times required.

What it covers

A190 is a consultation in which the psychiatrist provides all the elements of a psychiatric consultation (A195) and spends at least 75 minutes in direct contact with the patient, not counting other separately billable services (A183).

The time excludes non-patient-facing time such as reviewing charts or imaging, or documentation (A183).

Billing rules

Start and stop times must be in the chart, or the service is not payable (A183).
All consultation requirements apply: a written, signed request naming the referrer and billing number, kept in the chart, and a written report back. Otherwise it is paid as a lesser assessment (GP16).
The consultation limits apply to special consultations: same diagnosis, one per two consecutive 12-month periods; unrelated diagnosis, one per 12 months (GP17, GP18).
Detention (K001) is not payable for the same patient the same day (GP31). For longer visits, K630 consultation extension starts after 90 minutes: 1 unit needs 106 minutes in total, 2 units 136 (A185).
Out-of-hospital psychotherapy, psychiatric care or hypnotherapy the same day is not payable unless the diagnoses are clearly different (GP55).
Patients under 16: specialist consultation age premium of 10% to 30% (GP64).
Video only (with K300A), never telephone (AJ2). For hospital in-patients bill C190 (A186).

Often billed with

K300A when the consultation is done by video (A70, AJ2).
K630 psychiatric consultation extension, maximum six units per patient per physician per day (A185).

Common rejections

EH2: The health card version code on the claim doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit.

Related codes: A195, A795, A695, K630, A196, C190

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), pages A183 and A185; General Preamble GP16 to GP18 (consultations) and GP31 (detention)

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