What is OHIP billing code C133?

C133 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C133 pay?

The current OHIP fee for C133 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C133 to OHIP?

C133 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C133 claims against the Schedule of Benefits rules before submission.

What codes are related to C133?

Codes related to C133 in the Schedule of Benefits include A133, C134, C130, W133.

All codes

C133

C133 – Medical specific assessment

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

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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
A re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.
$83.40
C133 Medical specific assessment(this code)
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 medical specific assessment is a service rendered by a specialist in Internal Medicine in a hospital in-patient setting (non-emergency). It requires 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 per 12 month period if: (1) the patient presents a second time with a clearly different and unrelated diagnosis, or (2) at least 90 days have elapsed since the last specific assessment and the second assessment is a hospital admission assessment.

A133Medical specific assessment (Office/Out-patient)C134Medical specific re-assessment C130Comprehensive internal medicine consultation W133Subsequent visit - Nursing home (Long-term care)

C133 is the 'C' prefix (hospital in-patient) version of A133.

If the physician is already in the hospital and assesses one of their own patients, the service constitutes a subsequent visit unless it is the initial admission assessment.

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