What is OHIP billing code C095?

C095 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C095 pay?

The current OHIP fee for C095 is $113.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C095 to OHIP?

C095 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C095 claims against the Schedule of Benefits rules before submission.

What codes are related to C095?

Codes related to C095 in the Schedule of Benefits include C096, C935, C093, C094, E082.

All codes

C095

C095 – Consultation

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
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(this code)
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 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.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon (for insured dental procedures in hospital) is mandatory.

The consultant must prepare a written report (findings, opinions, recommendations) and send it to the referring provider.

The request must identify the consultant, the referrer, and the patient by name and billing/health numbers.

A copy of the written request must be kept in the medical record (common hospital records are acceptable).

Usage limits

Consultations for the same patient by the same physician for the same diagnosis are limited to one service per two consecutive 12-month periods (effectively once every 24 months), with specific exceptions for hospital in-patients where a second consultation may be eligible between 12 and 24 months.

C096Repeat consultation C935Special surgical consultation C093Specific assessment C094Specific re-assessment E082Admission assessment by the MRP premium

For emergency calls and other special visits to in-patients, use General Listings and Special Visit Premiums ( to ) when applicable.

Non-emergency hospital in-patient services are governed by General Preamble to .

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