What is OHIP billing code C063?

C063 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C063 pay?

The current OHIP fee for C063 is $45.55, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C063 to OHIP?

C063 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C063 claims against the Schedule of Benefits rules before submission.

What codes are related to C063?

Codes related to C063 in the Schedule of Benefits include C064, C065, C935, C066, E082.

All codes

C063

C063 – Specific assessment

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

Ask a question

Levels of this visit

The C06x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C064 Specific re-assessment
A specific re-assessment is a service rendered by a specialist in a non-emergency hospital in-patient setting.
$27.30
C063 Specific assessment(this code)
A specific assessment rendered by a specialist in Orthopaedic Surgery for a non-emergency hospital in-patient.
$45.55

Consultations

C066 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…
$55.35
C065 Consultation
A consultation rendered to a hospital in-patient by an Orthopaedic Surgeon (specialty 06) following a written request from a referring physician, nurse practitioner, or dental…
$89.80

A specific assessment rendered by a specialist in Orthopaedic Surgery for a non-emergency hospital in-patient. This service requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.

Requires a direct physical encounter with the patient including taking a patient history and performing a physical examination.

Requires a full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.

For surgeons (Orthopaedic Surgery), a hospital admission assessment is not eligible for payment unless it is the major preoperative visit (the assessment where the decision to operate is made).

Usage limits

Limited to one per patient per physician per 12-month period. This limit may be increased to two if the patient presents a second time with a clearly different diagnosis unrelated to the first assessment.

C064Specific re-assessment C065Consultation - non-emergency hospital in-patient C935Special surgical consultation - non-emergency hospital in-patient C066Repeat consultation - non-emergency hospital in-patient E082Admission assessment by the MRP premium

Non-Emergency Hospital In-Patient Services include Acute Care Hospitals.

If the specialist assessed the patient in the Emergency Department (ED) or Out-Patient Department (OPD) and subsequently admits the patient, that initial assessment constitutes the admission assessment.

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in