What is OHIP billing code C131?

C131 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C131 pay?

The current OHIP fee for C131 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C131 to OHIP?

C131 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C131 claims against the Schedule of Benefits rules before submission.

What codes are related to C131?

Codes related to C131 in the Schedule of Benefits include C133, C134, C130, C135.

All codes

C131

C131 – Complex medical specific re-assessment

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

Ask a question

Levels of this visit

The C13x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C134 Medical specific re-assessment
A medical specific re-assessment is an admission assessment rendered by an Internal Medicine specialist for the purpose of admitting a patient to an acute care hospital, when the…
$72.00
C131 Complex medical specific re-assessment(this code)
A re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.
$83.40
C133 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in Internal Medicine in a hospital in-patient setting (non-emergency).
$95.95

Consultations

C136 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…
$123.10
C135 Consultation
A consultation rendered by a specialist in Internal Medicine (13) to a hospital in-patient in a non-emergency setting.
$192.85
C130 Comprehensive internal medicine consultation
A consultation rendered by a specialist in internal medicine who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of…
$342.25

A re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition. This service includes all the requirements of a medical specific re-assessment (full history of the presenting complaint, necessary physical examination, advice to the patient, and appropriate record).

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

The physician must report findings, opinions, or recommendations in writing to the patient’s primary care physician.

Includes a full history of the presenting complaint and a physical examination of one or more systems.

Usage limits

Limited to 4 per patient per physician per 12-month period (individually and in combination with medical specific assessments).

C133Medical specific assessment C134Medical specific re-assessment C130Comprehensive internal medicine consultation C135Consultation

C131 is the hospital in-patient equivalent of the complex medical specific re-assessment.

Not eligible for age-based fee premiums (percentage increases).

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in