What is OHIP billing code C154?

C154 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C154 pay?

The current OHIP fee for C154 is $72.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C154 to OHIP?

C154 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C154 claims against the Schedule of Benefits rules before submission.

What codes are related to C154?

Codes related to C154 in the Schedule of Benefits include C153, C151, C152, W154.

All codes

C154

C154 – Medical specific re-assessment

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

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Levels of this visit

The C15x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C154 Medical specific re-assessment(this code)
A medical specific re-assessment is a service rendered by a specialist (Endocrinology & Metabolism) for a hospital in-patient, requiring a full, relevant history and physical…
$72.00
C151 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 and includes all the…
$83.40
C153 Medical specific assessment
A medical specific assessment rendered by a specialist in Endocrinology & Metabolism to a hospital in-patient.
$95.95

Consultations

C156 Repeat consultation
This service is a repeat consultation for a non-emergency hospital in-patient, rendered by a specialist in Endocrinology & Metabolism (15).
$110.15
C155 Consultation
A consultation rendered to a hospital in-patient by a specialist in Endocrinology & Metabolism (15) following a written request from a referring physician, nurse practitioner, or…
$172.95
C150 Comprehensive endocrinology consultation
A consultation rendered by a specialist in endocrinology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes in direct…
$342.25

A medical specific re-assessment is a service rendered by a specialist (Endocrinology & Metabolism) for a hospital in-patient, requiring a full, relevant history and physical examination of one or more systems.

Full, relevant history of the patient.

Physical examination of one or more systems.

Usage limits

Limited to two per patient per physician per consecutive 12 month period, except for specific re-assessments rendered for hospital admissions (where the physician assessed the patient prior to admission for the same illness). Excess services are adjusted to a lesser assessment fee.

C153Medical specific assessment C151Complex medical specific re-assessment C152Subsequent visit - first five weeks W154General re-assessment of patient in nursing home

Admission assessments are deemed to be a medical specific re-assessment if the patient was assessed by the physician prior to admission for the same illness.

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

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