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Billing code

A470A — Comprehensive Respiratory Disease Consultation

Long respirology consultation

Bill A470 for a respirology consultation with at least 75 minutes of direct patient contact, with start and stop times charted.

Watch for: Without start and stop times in the permanent record, it pays as a lesser fee.

Code

A470A

Description

Comprehensive Respiratory Disease 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

Comprehensive respirology consultation: a full consultation with at least 75 minutes of direct patient contact, start and stop times charted.

What it covers

A470 is a consultation by a specialist in Respiratory Disease who provides all the appropriate elements of a consultation and spends at least 75 minutes in direct contact with the patient, not counting any other separately billable service (A197).

Time excludes non-patient-facing work such as reviewing charts, imaging or documentation (A197 commentary).

Billing rules

• Record start and stop times in the permanent record, or it pays as a lesser fee (A197).
• Must satisfy all the elements of a consultation (A197, GP16).
• Needs a written, signed request naming you or the specialty, the referrer and their billing number, and the patient and health number, kept in your chart (a common hospital record is fine). Without it OHIP pays a lesser assessment (GP16).
• Same patient, same diagnosis: one consultation per two consecutive 12-month periods; a second is allowed only for an in-patient or ED patient 12 to 24 months after the first. Excess claims pay as an assessment (GP17, GP18). Comprehensive consultations count toward the limit (GP18).
• Detention (K001) is payable only after 120 minutes (GP31).
• Virtual care: video only, not phone, with an existing patient relationship; add K300A (AJ2, A66).

Often billed with

• Pulmonary function studies done the same day, such as J304 or J310 (H4–H5, J3).

Common rejections

• ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
• AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).

Related codes: A475, C470, A575, A476, K001

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A197. Rules GP16–GP18, GP31.

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