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Billing code

A590A — Comprehensive Rheumatology Consultation

Long rheumatology consultation

Bill A590 for a rheumatology consultation with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the chart, or it is paid at a lesser fee; the written referral is still required.

Code

A590A

Description

Comprehensive Rheumatology 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 rheumatology consultation: a full consultation with at least 75 minutes of direct patient contact. Start and stop times required.

What it covers

A590 is a consultation by a rheumatology specialist that includes all elements of a consultation and at least 75 minutes of direct contact with the patient, not counting time spent on other separately billable services (A200).

Time excludes any separately payable service or procedure and non-patient-facing work such as reviewing charts, imaging or documents (A200).

Billing rules

• Rendered by a specialist in rheumatology, with at least 75 minutes of direct contact (A200).
• Record start and stop times in the chart, or it is paid at a lesser fee (A200).
• Must meet all consultation requirements, including the written referral (A200, GP16).
• Counts toward the consultation limits: one per patient per physician for the same diagnosis in two consecutive 12-month periods (GP17–GP18).
• Detention (K001) may start only after 120 minutes (GP31).
• Age premium of 10–30% for patients under 16 (GP64).
• Video only (not telephone) as virtual care, with K300A (Appendix J, A66).

Often billed with

• K001 detention after the 120-minute minimum (GP31).

Common rejections

• ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16).
• AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual care list, so it can't be billed by telephone (K301A) (Appendix J).

Related codes: A485, C590, A595, A486, K001

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), page A200.

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