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Billing code

A375A — Geriatric limited consultation

Short geriatric consultation

A geriatrician bills A375 for a less demanding consultation that takes substantially less time but meets every consultation requirement.

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

Code

A375A

Description

Geriatric 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

Shorter, less demanding geriatric consultation that still meets all the requirements of a full consultation.

What it covers

A375 is the Geriatrics (07) limited consultation (A120). A limited consultation is less demanding and normally takes substantially less time than a full consultation; otherwise it has all the same requirements (GP19).

Like any consultation, it follows a written request and ends with a written report to the referrer (GP16).

Billing rules

• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Geriatrics (07) (GP9).
• Needs a written, signed request from a physician or nurse practitioner that names you or your specialty, the referrer and their billing number, and the patient and health number. Without it, OHIP pays a lesser assessment (GP16).
• Same patient, same consultant, same diagnosis: one consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first; a clearly unrelated diagnosis allows one every 12 months. Extra consultations pay as an assessment (GP17–GP18).
• A referral you ask for after seeing the patient does not make the visit a consultation; bill the visit you actually provided (GP16).
• Detention (K001) can be added only after 60 minutes of consultation time (GP30–GP31).
• Can be done by video only, not phone, with modality indicator K300A. A video consultation listed in Appendix J itself creates the patient relationship needed for virtual care (AJ2, A66, A70).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: A075, A076, A775, C375, W375, A073

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A120. Limited consultation GP19.

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