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Billing code

A895A — Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient

Psychiatry consultation on special visit

Bill A895 for a psychiatric consultation given on a special visit to a hospital in-patient, long-term care resident or emergency patient.

Watch for: Bill it with the matching special visit premium, and chart the visit time; not for rounds or elective admissions.

Code

A895A

Description

Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient

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

Psychiatric consultation given on a special visit to a hospital in-patient, long-term care resident or emergency department patient.

What it covers

A895 is a psychiatric consultation in association with a special visit to a hospital in-patient, a long-term care in-patient or an emergency department patient (A183).

A consultation is an assessment after a written request from a physician, nurse practitioner or (for hospital dental care) a dental surgeon, with a written report back to the referrer (GP16).

Billing rules

• Bill A895 with the matching special visit premium: a 'C' prefix premium for a hospital in-patient, 'W' for a long-term care in-patient, or 'K' for an emergency department patient (A183).
• Special visit premiums need a non-elective, patient-initiated visit; not for rounds or elective admissions, and the visit time must be charted (GP65, GP69).
• 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).
• K630 extension: the first unit starts after 60 minutes with the patient (76 minutes for one unit); maximum 6 units per day (A185).
• Detention (K001) is not payable the same day for the same patient (GP31).
• Not on the Appendix J virtual care lists, so it can't be billed virtually (AJ1–AJ2).

Often billed with

• Special visit premiums: C960–C997 (hospital in-patient), W960–W999 (long-term care) or K960–K999 (emergency department) (A183, GP70–GP73).
• K630 psychiatric consultation extension (A185).

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).

Related codes: A195, C895, W895, K630, C990, K990, W990

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A183. Special visit premiums GP65–GP78.

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