What is OHIP billing code C035?

C035 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C035 pay?

The current OHIP fee for C035 is $114.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C035 to OHIP?

C035 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C035 claims against the Schedule of Benefits rules before submission.

What codes are related to C035?

Codes related to C035 in the Schedule of Benefits include C033, C034, C122, C123, C124.

All codes

C035

C035 – Consultation

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

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Levels of this visit

The C03x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C034 Specific re-assessment
C034 is a specific re-assessment rendered by a specialist for a non-emergency hospital in-patient.
$36.75
C033 Specific assessment
A specific assessment for a non-emergency hospital in-patient provided by a physician with the specialty designation of General Surgery (03).
$56.40

Consultations

C036 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…
$76.45
C035 Consultation(this code)
A consultation rendered to a hospital in-patient by a specialist in General Surgery following a written request from a referring physician, nurse practitioner, or dental surgeon.
$114.75

A consultation rendered to a hospital in-patient by a specialist in General Surgery following a written request from a referring physician, nurse practitioner, or dental surgeon. The service includes a review of all relevant data and the preparation of a written report containing findings, opinions, and recommendations.

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

The request must identify the consultant, the referring provider (including billing number), and the patient.

A written report must be provided to the referring provider (and the primary care provider if the referral was by an NP).

The consultant must perform a general, specific, or medical specific assessment.

Usage limits

Limited to one service per patient per two consecutive 12-month periods for the same diagnosis by the same physician (except for repeat consultations or specific hospital/ED exceptions). Limited to one service every 12 months for a clearly defined unrelated diagnosis.

C033Specific assessment C034Specific re-assessment C122Subsequent visit by the MRP - day following admission C123Subsequent visit by the MRP - second day following admission C124Subsequent visit by the MRP - day of discharge

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

Pre-operative consultations for low-risk elective procedures (e.g., cataract, colonoscopy) are only eligible if the medical record demonstrates specific medical necessity.

C035 constitutes the admission assessment if the admitting physician has not assessed the patient for the same illness within the previous 90 days.

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