What is OHIP billing code C113?

C113 is "Complex neurological assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C113 pay?

The current OHIP fee for C113 is $120.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C113 to OHIP?

C113 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C113 claims against the Schedule of Benefits rules before submission.

What codes are related to C113?

Codes related to C113 in the Schedule of Benefits include A113, W113, C510.

All codes

C113

C113 – Complex neurological 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
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(this code)
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

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 where the visit requires a minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.

Minimum of 20 minutes in direct contact with the patient.

The start and stop times must be recorded in the patient’s permanent medical record.

Must include the elements of a medical specific re-assessment.

The patient must have an established diagnosis of a chronic complex neurological disease, documented in the medical record.

Usage limits

Limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

A113Complex neurological assessment (Out-patient)W113Complex neurological assessment (Long-term care)C510Complex neuromuscular assessment (Physical Medicine & Rehabilitation)

Eligible conditions include: (1) Neuromuscular system diseases (generalized peripheral neuropathies, myopathies, diseases of the neuromuscular junction, or motor neurone diseases); (2) Chronic CNS disorders (malignant brain neoplasms, functional neurological disorder, chronic migraine/trigeminal autonomic cephalalgias, Huntington’s chorea, trigeminal neuralgia, intracranial hemorrhage, stroke); (3) Neuro-oncology conditions (primary CNS tumor, CNS metastasis, neurological complications of cancer therapy, paraneoplastic neurological syndromes).

Not intended for the evaluation and/or management of uncomplicated neurological disorders (e.g., carpal tunnel syndrome, Bell’s palsy, asymptomatic diabetic neuropathy).

A consultation or assessment service should be claimed for the initial evaluation; C113 is for ongoing management.

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