What is OHIP billing code C111?

C111 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C111 pay?

The current OHIP fee for C111 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C111 to OHIP?

C111 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C111 claims against the Schedule of Benefits rules before submission.

What codes are related to C111?

Codes related to C111 in the Schedule of Benefits include A111, C713, C114, C112, C118.

All codes

C111

C111 – Complex medical specific re-assessment

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

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Levels of this visit

The C11x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C114 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in Critical Care Medicine for a hospital in-patient.
$72.00
C111 Complex medical specific re-assessment(this code)
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.
$83.40
C113 Complex neurological assessment
An assessment for the ongoing management of complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and…
$120.00

Consultations

C116 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…
$122.00

A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition. It includes all the requirements of a medical specific re-assessment, which requires a full, relevant history and physical examination of one or more systems.

The patient's condition must be complex, obscure, or serious.

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

The physician must report findings, opinions, or recommendations in writing to the patient’s primary care physician; otherwise, the fee will be adjusted to a lesser assessment fee (typically a partial assessment).

Usage limits

Limited to 4 per patient per physician per 12-month period. This limit is shared with medical specific assessments (C713).

A111Complex medical specific re-assessment (Office/Out-patient version)C713Medical specific assessment (Hospital)C114Medical specific re-assessment (Hospital)C112Subsequent visit, first five weeks C118Partial assessment (Hospital)

The fee for C111 is $83.40 (as per the Numeric Index effective April 1, 2026).

If the written report requirement is not met, the claim may be adjusted to a Partial Assessment fee (C118).

Special Visit Premiums (SVPs) may apply if the physician is called to the hospital specifically to see the patient (see -).

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