What is OHIP billing code C064?

C064 is "Specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C064 pay?

The current OHIP fee for C064 is $27.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C064 to OHIP?

C064 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C064 claims against the Schedule of Benefits rules before submission.

What codes are related to C064?

Codes related to C064 in the Schedule of Benefits include C065, C935, C066, C063, C062, C122.

All codes

C064

C064 – Specific re-assessment

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

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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(this code)
A specific re-assessment is a service rendered by a specialist in a non-emergency hospital in-patient setting.
$27.30
C063 Specific assessment
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 re-assessment is a service rendered by a specialist in a non-emergency hospital in-patient setting. It requires a full, relevant history and physical examination of one or more systems.

Requires a full, relevant history.

Requires a physical examination of one or more systems.

Must include the specific elements of assessments as defined in (direct physical encounter, history, physical exam, inquiry, procedures, arrangements, follow-up, discussion, monitoring, etc.).

Usage limits

Limited to two per patient per physician per consecutive 12 month period, except for specific re-assessments rendered for hospital admissions. Amounts in excess of this limit will be adjusted to a lesser assessment fee.

C065Consultation C935Special surgical consultation C066Repeat consultation C063Specific assessment C062Subsequent visit (first five weeks)C122MRP subsequent visit (day following admission)

C064 is specifically for Orthopaedic Surgery (06) in the hospital in-patient setting.

For surgical specialists, the admission assessment is deemed a specific re-assessment if the physician has assessed the patient prior to admission in respect of the same illness.

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