What is OHIP billing code C003?

C003 is "General assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C003 pay?

The current OHIP fee for C003 is $89.65, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C003 to OHIP?

C003 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C003 claims against the Schedule of Benefits rules before submission.

What codes are related to C003?

Codes related to C003 in the Schedule of Benefits include C004, C005, C933.

All codes

C003

C003 – General assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The C00x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C004 General re-assessment
A general re-assessment includes all the services listed for a general assessment, with the exception of the patient’s history, which need not include all the details already…
$38.35
C003 General assessment(this code)
A general assessment is a service rendered for a hospital in-patient that requires a full history (including history of the presenting complaint, family medical history, past…
$89.65

Consultations

C006 Repeat consultation
An additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval…
$47.10
C005 Consultation
A consultation rendered by a family or general practitioner for a non-emergency hospital in-patient.
$95.60

A general assessment is a service rendered for a hospital in-patient that requires a full history (including history of the presenting complaint, family medical history, past medical history, social history, and a functional inquiry into all body parts and systems) and, except for breast, genital or rectal examination where not medically indicated or refused, an examination of all body parts and systems. It may include a detailed examination of one or more parts or systems.

Requires a full history: presenting complaint, family medical, past medical, social, and functional inquiry into all body parts and systems.

Requires a physical examination of all body parts and systems (except breast, genital, or rectal if not indicated or refused).

Usage limits

Limited to one per patient per physician per 12-month period. The limit is increased to two per 12-month period if: (1) the patient presents a second time with a clearly different and unrelated diagnosis, or (2) at least 90 days have elapsed since the last general assessment and the second is a hospital admission assessment. Excess claims are adjusted to a lesser assessment fee.

C004General re-assessment C005Consultation C933On-call admission assessment

C003 is specifically for non-emergency hospital in-patient services.

Not eligible for virtual care billing (not listed in Appendix J).

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