What is OHIP billing code C093?

C093 is "Specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C093 pay?

The current OHIP fee for C093 is $55.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C093 to OHIP?

C093 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C093 claims against the Schedule of Benefits rules before submission.

What codes are related to C093?

Codes related to C093 in the Schedule of Benefits include A093, C094, C095, C935, C096, C092.

All codes

C093

C093 – Specific assessment

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

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Levels of this visit

The C09x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C094 Specific re-assessment
A service rendered by a specialist (Cardiac Surgery) in a hospital in-patient setting, requiring a full, relevant history and physical examination of one or more systems.
$32.70
C093 Specific assessment(this code)
A specific assessment is a service rendered by a specialist in Cardiac Surgery for a hospital in-patient, requiring a full history of the presenting complaint and a detailed…
$55.70

Consultations

C096 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…
$75.20
C095 Consultation
A consultation rendered to a non-emergency hospital in-patient by a Cardiac Surgeon following a written request from a referring physician, nurse practitioner, or dental surgeon.
$113.15

A specific assessment is a service rendered by a specialist in Cardiac Surgery for a hospital in-patient, requiring 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.

Full history of the presenting complaint.

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.

Usage limits

Limited to one per patient per physician per 12-month period. The limit is increased to two if: (1) the patient presents a second time with a clearly different diagnosis unrelated to the first, or (2) at least 90 days have elapsed since the last specific assessment and the second is a hospital admission assessment. Services in excess of these limits are adjusted to a lesser assessment fee.

A093Specific assessment (General Listing/Office)C094Specific re-assessment C095Consultation (Hospital In-Patient)C935Special surgical consultation C096Repeat consultation C092Subsequent visit - first five weeks

When a patient is assessed by a specialist in the ED or OPD and subsequently admitted, the initial assessment constitutes the admission assessment.

C093 is listed under 'NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES' for Cardiac Surgery (09).

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