What are the billing rules for A575A?

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). Detention (K001) is payable only after 60 minutes (GP30).

Why is A575A rejected?

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).

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Billing code

A575A — Respiratory disease limited consultation

Q: What is OHIP billing code A575A?

Limited consultation by a respirologist: a less demanding consultation that needs much less time than a full one.

Respirology limited consultation

Bill A575 for a respirologist's less demanding consultation that takes much less time than a full one.

Watch for: Keep the signed written request with the referrer's billing number in your chart, or OHIP pays a lesser assessment.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$119.35	$0.00	$0.00	$0.00

Code: A575A
Description: Respiratory disease 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 consultation by a respirologist: a less demanding consultation that needs much less time than a full one.

What it covers

A575 is a limited consultation by a specialist in Respiratory Disease (A197).

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 (GP19).

Billing rules

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).
Detention (K001) is payable only after 60 minutes (GP30).
Virtual care: video only, not phone, with an existing patient relationship; add K300A (AJ2, A66).

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, A470, A476, C575, A473

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A197. Rules GP16–GP19.

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