What is OHIP billing code C015?

C015 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C015 pay?

The current OHIP fee for C015 is $109.70, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill C015 to OHIP?

C015 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C015 claims against the Schedule of Benefits rules before submission.

What codes are related to C015?

Codes related to C015 in the Schedule of Benefits include A015, C016, C210, C215.

All codes

C015

C015 – Consultation

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

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Levels of this visit

The C01x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C014 Specific re-assessment
A specific re-assessment is a service rendered by a specialist (specifically Anaesthesia for code C014) to a hospital in-patient.
$28.00
C013 Specific assessment
A service rendered by a specialist in anaesthesia for a hospital in-patient, requiring a full history of the presenting complaint and detailed examination of the affected part(s)…
$64.65

Consultations

C016 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another…
$52.15
C015 Consultation(this code)
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for insured dental procedures in hospital).
$109.70

A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for insured dental procedures in hospital). The consultant physician must be competent to give advice due to the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient. The service includes a written report of findings, opinions, and recommendations to the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon must be recorded in the patient's medical record.

The consultant must provide a written report to the referring provider.

The service must include a general, specific, or medical specific assessment and a review of all relevant data.

Routine pre-anaesthetic evaluations required by the Public Hospitals Act do not constitute a consultation and are included in the anaesthesia service fee.

Usage limits

Limited to one consultation per patient by the same physician for the same diagnosis per two consecutive 12-month periods (except for repeat consultations or specific hospital/ED exceptions).

A015Consultation (Anaesthesia - Office/Out-patient)C016Repeat consultation C210Special anaesthetic consultation C215Limited consultation for acute pain management

Subject to the same conditions as A015 (office/out-patient consultation).

If the referral is from a nurse practitioner, the report must be sent to the NP and the patient's primary care provider (if applicable).

If the requirements for a consultation are not met (e.g., no written request), the fee will be adjusted to a lesser assessment fee.

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