Billing code
A255A — Endocrinology limited consultation
Short endocrinology consultation
An endocrinologist bills A255 for a referred consultation that needs substantially less time than a full consultation.
Watch for: Put the referrer's billing number on the claim; virtually, consultations are video only, not telephone.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $110.15 | $0.00 | $0.00 | $0.00 |
- Code
- A255A
- Description
- Endocrinology limited 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
Limited consultation by an endocrinology specialist: a referred consultation that needs substantially less time than a full one.
What it covers
A255 is a limited consultation in Endocrinology & Metabolism (15) (A98). A limited consultation is less demanding and normally needs substantially less of the physician's time than a full consultation. Otherwise it has the same requirements (GP19).
A full consultation is A155, a comprehensive endocrinology consultation (at least 75 minutes) is A150, and a repeat consultation is A156 (A98).
Billing rules
- Needs a written, signed request from a physician, nurse practitioner, or dental surgeon for a hospital dental service. It must name the consultant or specialty, the referrer and billing number, and the patient and health number. Without it, payment drops to a lesser assessment (GP16).
- Send a written report with findings, opinions and recommendations to the referring provider (GP16).
- Consultation limits apply: for the same diagnosis, 1 per patient per physician per two consecutive 12-month periods (a second is allowed 12–24 months later for an in-patient or ED patient); for a clearly unrelated diagnosis, 1 per 12 months. Excess consultations are paid as an assessment (GP17, GP18).
- A consultation requested after the service has been done is not payable as a consultation (GP16).
- Patients under 16: payment is increased by 10% to 30% depending on age (GP64).
- Can be done by video, but not by phone, as Comprehensive Virtual Care; add K300A (Appendix J AJ2, A66).
Common rejections
- ARF: The referring provider's number is missing. A consultation needs a referral from a physician or nurse practitioner, identified by billing number (GP16).
- AT2: Billed as phone virtual care. Consultations are video-only under Appendix J (AJ2).
- A4D: The billing specialty doesn't match. A255 is listed under Endocrinology & Metabolism (15) (A98).
Related codes: A155, A150, A156, A153, A154, A151, A158
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A98; definitions GP16–GP19.
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