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C025 – Consultation

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

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Levels of this visit

The C02x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • C024 Specific re-assessment

    A specific re-assessment is a service rendered by a specialist in a hospital in-patient setting (non-emergency) that requires a full, relevant history and physical examination of…

    $27.25

  • C023 Specific assessment

    Specific assessment, Dermatology (02), non-emergency hospital in-patient services (see General Preamble GP40 to GP48).

    $46.15

  • C020 Complex dermatology assessment

    A complex dermatology assessment is an in-patient assessment for the ongoing management of specific complex dermatological diseases where the complexity of the condition requires…

    $60.00

Consultations

  • C026 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…

    $47.75

  • C025 Consultation(this code)

    A consultation rendered to a non-emergency hospital in-patient by a Dermatology specialist following a written request from a referring physician, nurse practitioner, or dental…

    $158.15
A consultation rendered to a non-emergency hospital in-patient by a Dermatology specialist following a written request from a referring physician, nurse practitioner, or dental surgeon. The service includes the necessary assessment and the preparation of a written report containing findings, opinions, and recommendations.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The consultant must provide a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.
The service must include a general, specific or medical specific assessment, including a review of all relevant data.
The written request sets out the information relevant to the referral and specifies the service(s) required.
Usage limits
Only one consultation, general or specific assessment, or reassessment is eligible for payment per patient admission when a patient is transferred between physicians.
C026Repeat consultationC023Specific assessmentC024Specific re-assessmentC020Complex dermatology assessment

C025 is specifically for non-emergency (routine) in-patient services.

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

If the specialist admits the patient, the consultation (C025) constitutes the admission assessment and no separate admission assessment code is billable.

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