Billing code
A195A — Consultation
Psychiatry consultation
A psychiatrist bills A195 for an assessment at a physician's or nurse practitioner's written request, with a written report back.
Watch for: Enter the referrer's six-digit billing number from the signed request; on special visits to in-patients or emergency patients, bill A895 instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $254.30 | $0.00 | $0.00 | $0.00 |
- Code
- A195A
- Description
- 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
Psychiatry (19) consultation: a psychiatrist's assessment at the written request of a referring physician or nurse practitioner, with a report.
What it covers
A195 is the Psychiatry (19) consultation (A183): an assessment after a written request from a referring physician, nurse practitioner or dental surgeon, because of the complexity, seriousness or obscurity of the case, or because the patient asked for another opinion (GP16).
It includes the written report to the referrer and, unless stated otherwise, a general, specific or medical specific assessment with review of all relevant data (GP16).
Billing rules
- Needs a written, signed request from a physician or nurse practitioner (or a dental surgeon for in-hospital dental care) naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart. The consultant sends a written report back. Otherwise it is paid as a lesser assessment, and a request obtained after the service doesn't count (GP16).
- Same patient, physician and diagnosis: one consultation per two consecutive 12-month periods (a second only for an in-patient or ED patient 12 to 24 months later). Unrelated diagnosis: one per 12 months. Extras are paid as an assessment (GP17, GP18).
- On a special visit to a hospital in-patient, LTC in-patient or ED patient, bill A895 with the C-, W- or K-prefix special visit premium instead (A183).
- Longer consultations: A190 special (75 minutes or more), A795 geriatric (age 75 or older) and A695 neurodevelopmental (A183).
- Detention (K001) is not payable for the same patient on the same day as A195 (GP31).
- 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).
Common rejections
- AC4: The referring provider number was missing, mistyped, your own number, or from a provider type that can't refer for this code. Enter the referrer's six-digit number from the request.
- EH2: The health card version code doesn't match the Ministry's record. Get the current version code and resubmit.
- A4D: The code is in the Psychiatry (19) listing, and specialists bill from their own specialty's listing (GP9). The specialty on the claim can't bill it.
- AC1: A limit was reached. Consultations over the GP17 limits are payable only as an assessment, such as A193, so resubmit with that code.
Related codes: A895, A190, A795, A695, A395, A196, A193
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), pages A183 to A184; General Preamble GP16 to GP19 (consultations)
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