What is OHIP billing code C054?

C054 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C054 pay?

The current OHIP fee for C054 is $64.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C054 to OHIP?

C054 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C054 claims against the Schedule of Benefits rules before submission.

What codes are related to C054?

Codes related to C054 in the Schedule of Benefits include C053, C051, C052, C124.

All codes

C054

C054 – Medical specific re-assessment

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

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Levels of this visit

The C05x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C054 Medical specific re-assessment(this code)
A medical specific re-assessment is a service rendered by a specialist in an acute care hospital (non-emergency in-patient) requiring a full, relevant history and physical…
$64.30
C051 Complex medical specific re-assessment
A re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.
$74.45
C053 Medical specific assessment
A medical specific assessment rendered by a specialist in Community Medicine for a non-emergency hospital in-patient.
$83.85

Consultations

C056 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…
$94.75
C055 Consultation
A consultation rendered to a hospital in-patient by a specialist in Community Medicine (05) following a written request from a referring physician, nurse practitioner, or dental…
$152.80
C050 Special community medicine consultation
This service is a consultation rendered by a specialist in community medicine who provides all the appropriate elements of a consultation and spends a minimum of 50 minutes in…
$176.10

A medical specific re-assessment is a service rendered by a specialist in an acute care hospital (non-emergency in-patient) requiring a full, relevant history and physical examination of one or more systems.

Requires a full, relevant history and physical examination of one or more systems.

Must be rendered in an acute care hospital for a non-emergency in-patient.

Usage limits

Limited to two per patient per physician per consecutive 12-month period, except for specific re-assessments rendered for hospital admissions.

C053Medical specific assessment C051Complex medical specific re-assessment C052Subsequent visit - first five weeks C124Subsequent visit - day of discharge

C-prefix codes are designated for Acute Care Hospital - Non-Emergency In-Patient Services.

If the limit of 2 per 12 months is exceeded (and it is not an admission assessment), the fee is adjusted to a lesser assessment fee.

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