< Billing codes

Billing code

A205A — Obstetrics and gynaecology consultation

OB/GYN consultation

An obstetrician-gynaecologist bills A205 for a consultation in the office or general setting at a referring provider's written request.

Watch for: Put the referrer's billing number on the claim; virtually, it can be done by video only, not telephone.

Code

A205A

Description

Obstetrics and gynaecology 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

An obstetrician-gynaecologist's consultation in the office or general setting, at the written request of a referring provider.

What it covers

A consultation is an assessment done 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 another opinion is requested. The consultant does a general, specific or medical specific assessment, reviews relevant data, and sends a written report (GP16).

A205 is the Obstetrics and Gynaecology (20) office and general listing. Includes, where indicated, biopsy of the cervix, collection of cervical cancer screening specimen(s) and examination of a trichomonas suspension (A151).

Billing rules

• Keep the signed written request. It must name you or your specialty, the referrer with billing number, and the patient with health number, or it is paid as a lesser assessment (GP16).
• Same patient, same diagnosis: 1 consultation per two consecutive 12-month periods; a second is allowed only for an in-patient or ED patient 12 to 24 months after the first. A clearly unrelated diagnosis allows 1 every 12 months (GP17).
• If an obstetrical patient is referred to you because of the complexity, obscurity or seriousness of the case, you can claim a consultation in addition to prenatal visits (K2).
• Add E432 when a pelvic exam with speculum is done outside a hospital or ICHSC. E432 is limited to one per patient per day, must be done personally, and is not payable with E430, E431 or E542 (A150).
• Cervical screening collection is included when the pelvic exam is a normal part of the visit, but E430 or E431 can be added when it is done outside a hospital or ICHSC (A150).
• Patients under 16 get an age premium of 10% to 30% on specialist consultations (GP64).
• Can be done by video only (not phone) with an existing patient-physician relationship; add K300A (Appendix J AJ2, A70).

Often billed with

• E432 pelvic exam with speculum outside hospital or ICHSC (A150).
• E430 or E431 cervical cancer screening collection outside hospital or ICHSC (A150).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation needs the referring physician's or nurse practitioner's billing number from the written request (GP16).
• AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual list, so it can't be billed by phone (K301A) (Appendix J AJ2).

Related codes: A206, A203, A204, A935, C205, E432

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Obstetrics and Gynaecology (20), page A150. Rules GP16–GP18.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing