A795 OHIP Billing Code: Comprehensive Geriatric Psychiatric Consultation

A795 is an OHIP billing code designated for geriatric psychiatric consultations, aimed at providing a detailed assessment and management plan for elderly patients. Typical clinical scenarios include late-onset depression with cognitive impairment, behavioral symptoms of dementia with caregiver strain, late-life psychosis, and long-standing psychiatric conditions occurring with new frailties and polypharmacy.

To effectively bill this code, psychiatrists must dedicate significant patient-facing time — at least 75 minutes of direct contact — which uniquely positions them to disentangle complex geriatric mental health issues. It is important to note that time spent on chart reviews or other non-patient-facing activities cannot be counted towards the consultation duration, which is a common oversight.

To be eligible for billing code A795, the following criteria must be met:

• The service provided is a geriatric psychiatric consultation, requiring the psychiatrist to spend a minimum of 75 minutes in direct patient contact.
• This code can be billed once in a two consecutive 12-month period for the same patient, same physician, and same diagnosis. A second service in the same period is allowed if conducted more than 12 months apart in a hospital inpatient or emergency department setting.
• If the service addresses a clearly defined unrelated diagnosis, it is billable once every 12 months.
• Excess services may be reimbursed at the general or specific assessment rate.
• Virtual consultations are eligible under code A795A, but must be conducted via video, not telephone.