Billing code
A355A — Urology consultation
Urology consultation
A urologist bills A355 for a consultation following a written referral, in the office or another general setting.
Watch for: Put the referrer's billing number on the claim; virtually, it can be done by video only, not telephone.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $93.15 | $0.00 | $0.00 | $0.00 |
- Code
- A355A
- Description
- Urology 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
Consultation by a urologist following a written referral, in the office or other general setting.
What it covers
A355 is the urology consultation (A206). A consultation is an assessment requested in writing by a physician or nurse practitioner because of the complexity, seriousness or obscurity of the case, or for another opinion (GP16).
It includes the needed assessment, review of relevant data and a written report to the referrer (GP16). A consultation with at least 50 minutes of direct contact is the special surgical consultation, A935 (A206, GP19).
Billing rules
- Needs a written, signed request naming you or your specialty, the referrer and billing number, and the patient and health number, kept on the chart; otherwise paid as a lesser assessment (GP16).
- Limited to one per patient per physician for the same diagnosis in two consecutive 12-month periods (a second only for an in-patient or ED consult 12–24 months after the first); one per 12 months for a clearly unrelated diagnosis (GP17).
- Starred (*) urology consults and assessments may include a genito-urinary exam and, when needed, urethral calibration, catheterization and prostatic fluid examination, but not endoscopy (A207).
- A pre-operative consultation before cystoscopy under local anaesthesia and/or IV sedation is only payable when the chart shows it was medically necessary (GP18).
- Age premium of 10–30% for patients under 16 (GP64).
- Detention (K001) may start after 60 minutes (GP30).
- Video only (not telephone) as virtual care, with K300A (Appendix J, A66).
- The surgical fee doesn't include the major pre-operative visit, so the decision-to-operate consultation is billed separately (SP2).
Often billed with
- K001 detention after the 60-minute minimum (GP30).
Common rejections
- ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16).
- AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual care list, so it can't be billed by telephone (K301A) (Appendix J).
Related codes: A935, A356, A353, A354, C355
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Urology (35), page A206.
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