What are the billing rules for A395A?

Needs a written, signed request from a physician or nurse practitioner, kept in the chart, and a written report back, or it is paid as a lesser assessment (GP16). Consultation limits apply: same patient, same diagnosis, one per two consecutive 12-month periods (with the in-patient/ED exception), or one per 12 months for a clearly unrelated diagnosis; extras are paid as an assessment (GP17–GP18). Age premiums apply for patients under 16, from 10% to 30% by age (GP64).

Why is A395A rejected?

ARF: OHIP describes this as 'Missing Physician Referring Number'. A consultation is paid only on a written referral from a physician or nurse practitioner (GP16); enter the referrer's billing number. AT4: OHIP describes this as 'Modality Not Allowed': this code is on the video-only list, so it can't be billed with K301A (telephone) (Appendix J).

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Billing code

A395A — Limited consultation – psychiatry

Q: What is OHIP billing code A395A?

Limited psychiatric consultation: a less demanding consultation that takes substantially less time than a full one.

Short psychiatry consultation

A psychiatrist bills A395 for a referred consultation that 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	$120.30	$0.00	$0.00	$0.00

Code: A395A
Description: Limited consultation – psychiatry
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 psychiatric consultation: a less demanding consultation that takes substantially less time than a full one.

What it covers

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

A395 is the psychiatry general listing; hospital in-patient and long-term care versions are C395 and W395 (A184, A186, A187).

Billing rules

Needs a written, signed request from a physician or nurse practitioner, kept in the chart, and a written report back, or it is paid as a lesser assessment (GP16).
Consultation limits apply: same patient, same diagnosis, one per two consecutive 12-month periods (with the in-patient/ED exception), or one per 12 months for a clearly unrelated diagnosis; extras are paid as an assessment (GP17–GP18).
Age premiums apply for patients under 16, from 10% to 30% by age (GP64).
By video only (not phone) with an existing patient relationship; add K300A (Appendix J, A70).

Common rejections

ARF: OHIP describes this as 'Missing Physician Referring Number'. A consultation is paid only on a written referral from a physician or nurse practitioner (GP16); enter the referrer's billing number.
AT4: OHIP describes this as 'Modality Not Allowed': this code is on the video-only list, so it can't be billed with K301A (telephone) (Appendix J).

Related codes: A195, A196, A193, A194, C395, W395

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A184; rules GP19.

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