What are the billing rules for A385A?

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's health number; otherwise it is paid as a lesser assessment (GP16). Same patient, same diagnosis: one consultation per two consecutive 12-month periods (a second only for a hospital in-patient or ED patient 12–24 months after the first); a clearly unrelated diagnosis allows one per 12 months. Excess claims are paid as an assessment (GP17–GP18). Age premiums apply for patients under 16, from +10% to +30% depending on age (GP64).

Why is A385A rejected?

ARF: The claim has no referring provider number. A consultation must follow a written referral that identifies the referring physician or nurse practitioner and their billing number (GP16). AT2: Billed by telephone (K301A). This code is on Appendix J's video-only list, so it must be done by video and claimed with K300A (AJ2).

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Billing code

A385A — Neurology limited consultation

Q: What is OHIP billing code A385A?

Limited neurology consultation: a less demanding referral that takes substantially less time than a full consultation.

Short neurology consultation

A neurologist bills A385 for a referred consultation that is less demanding and takes substantially less time than a full one.

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	$125.50	$0.00	$0.00	$0.00

Code: A385A
Description: Neurology 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 neurology consultation: a less demanding referral that takes substantially less time than a full consultation.

What it covers

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

A385 is the neurology office version; the full consultation is A185 (A140).

Billing rules

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's health number; otherwise it is paid as a lesser assessment (GP16).
Same patient, same diagnosis: one consultation per two consecutive 12-month periods (a second only for a hospital in-patient or ED patient 12–24 months after the first); a clearly unrelated diagnosis allows one per 12 months. Excess claims are paid as an assessment (GP17–GP18).
Age premiums apply for patients under 16, from +10% to +30% depending on age (GP64).
Can be done by video only (not telephone); add K300A to the claim (Appendix J AJ2, A66).

Common rejections

ARF: The claim has no referring provider number. A consultation must follow a written referral that identifies the referring physician or nurse practitioner and their billing number (GP16).
AT2: Billed by telephone (K301A). This code is on Appendix J's video-only list, so it must be done by video and claimed with K300A (AJ2).

Related codes: A185, A186, A183, A188, C385

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A140; rules GP16–GP19.

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