Billing code
A905A — Limited consultation
Family practice limited consultation
Bill A905 for a referred consultation by a non-specialist where only a specific-assessment level of service was needed.
Watch for: Needs a signed written request with the referrer's billing number kept in the chart, or it pays as a lesser assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $80.15 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- A905A
- Description
- 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
Family practice limited consultation: a referred consultation where the referral only needed a specific-assessment level of service.
What it covers
A limited consultation is less demanding than a full consultation and normally takes much less time, but has the same requirements (GP19).
Under Family Practice, it is the service by a non-specialist that meets all the requirements of a consultation, but where, because of the nature of the referral, only the services of a specific assessment were rendered (GP19).
Billing rules
- Needs a written, signed request from a physician or nurse practitioner (or a dental surgeon for in-hospital dental care) naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart. The consultant sends a written report back. Otherwise it is paid as a lesser assessment, and a request obtained after the service doesn't count (GP16).
- Same patient, physician and diagnosis: one consultation per two consecutive 12-month periods (a second only for an in-patient or ED patient 12 to 24 months later). Unrelated diagnosis: one per 12 months. Extras are paid as an assessment (GP17, GP18).
- The consultation limits apply to all consultations, including limited ones (GP18).
- A905 is not on the Appendix J list, so it can't be billed by video or telephone. GP focused practice physicians have a video code, A906 (A72, AJ1, AJ2).
Often billed with
- E079 smoking cessation initial discussion, once per patient per 12 months (A56).
Common rejections
- AC4: The referring provider number was missing, mistyped, your own number, or from a provider type that can't refer for this code. Enter the referrer's six-digit number from the request.
- EH2: The health card version code doesn't match the Ministry's record. Get the current version code and resubmit.
- VH8: The date of birth doesn't match OHIP's record for the health number. Correct it and resubmit.
- AC1: A limit was reached and OHIP asks for a different fee code. Consultations over the GP17 limits are payable only as an assessment, so resubmit with the assessment code that fits the service.
Related codes: A005, A006, A906, A007
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A3; General Preamble GP16 to GP19 (consultations, limited consultation)
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