Billing code
A435A — Internal medicine limited consultation
Internal medicine limited consultation
Bill A435 for an internist's shorter, less demanding consultation that still meets all the requirements of a full consultation.
Watch for: Needs a signed written request naming the referrer and their billing number, or OHIP pays a lesser assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $123.10 | $0.00 | $0.00 | $0.00 |
- Code
- A435A
- Description
- Internal medicine 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 consultation by an internist that still meets all the requirements of a full consultation.
What it covers
A435 is the Internal Medicine (13) limited consultation in the General Listings (A129). A limited consultation is less demanding and normally takes substantially less time than a full consultation; otherwise it has all the same requirements (GP19).
Billing rules
- Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Internal Medicine (13) (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: A135, A136, A130, C435, W435, A133
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A129. Consultation rules GP16–GP19.
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