What are the billing rules for A605A?

The written, signed request must name you or your specialty, the referrer and billing number, and the patient and health number; otherwise it is paid as a lesser assessment (GP16). Limit one consultation per patient for the same diagnosis per two consecutive 12-month periods (a second only for an in-patient or ED patient 12 to 24 months later); one per 12 months for an unrelated diagnosis. Extras are paid as an assessment (GP17, GP18). A pre-operative consultation before cataract surgery, colonoscopy, cystoscopy, carpal tunnel or arthroscopic surgery under local and/or IV sedation is paid only when the chart shows it was medically necessary (GP18).

Why is A605A rejected?

ARF: 'Missing physician referring number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16). AT2: 'Must include video modality': this consultation is video-only as virtual care; it can't be billed by phone (Appendix J AJ2).

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Billing code

A605A — Cardiology consultation

Q: What is OHIP billing code A605A?

Consultation by a cardiologist, on a written request from a physician or nurse practitioner, with a written report back.

Cardiology consultation

Bill A605 for a cardiologist's consultation on a written request from a physician or nurse practitioner, with a written report back.

Watch for: The signed request must name the referrer and their billing number, or it is paid as a lesser assessment.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$188.45	$0.00	$0.00	$0.00

Code: A605A
Description: Cardiology 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

Consultation by a cardiologist, on a written request from a physician or nurse practitioner, with a written report back.

What it covers

A consultation is an assessment after a written request from a physician or nurse practitioner who wants your opinion because of the complexity, seriousness or obscurity of the case, or because the patient asked for another opinion (GP16). A605 is the cardiology (60) consultation (A79).

It includes a general, specific or medical specific assessment, a review of relevant data, and a written report with findings, opinions and recommendations to the referring provider (GP16).

Billing rules

The written, signed request must name you or your specialty, the referrer and billing number, and the patient and health number; otherwise it is paid as a lesser assessment (GP16).
Limit one consultation per patient for the same diagnosis per two consecutive 12-month periods (a second only for an in-patient or ED patient 12 to 24 months later); one per 12 months for an unrelated diagnosis. Extras are paid as an assessment (GP17, GP18).
A pre-operative consultation before cataract surgery, colonoscopy, cystoscopy, carpal tunnel or arthroscopic surgery under local and/or IV sedation is paid only when the chart shows it was medically necessary (GP18).
Patients under 16: specialist consultations get an automatic age premium (GP64).
Detention (K001) can start only after 60 minutes (GP30).
Video only as virtual care (Appendix J AJ2).
For services not listed under Cardiology, refer to the Internal Medicine section (A79).

Common rejections

ARF: 'Missing physician referring number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
AT2: 'Must include video modality': this consultation is video-only as virtual care; it can't be billed by phone (Appendix J AJ2).

Related codes: A600, A675, A606, C605, A603, A604

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Cardiology (60), page A79; rules GP16–GP18.

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