What is OHIP billing code C155?

C155 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C155 pay?

The current OHIP fee for C155 is $172.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C155 to OHIP?

C155 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C155 claims against the Schedule of Benefits rules before submission.

What codes are related to C155?

Codes related to C155 in the Schedule of Benefits include A155, W155, C760, K045, A155, W155, C760, K045.

All codes

C155

C155 – Consultation

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
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(this code)
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 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 dental surgeon.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A written request from a referring physician, nurse practitioner, or dental surgeon must be kept in the consulting physician’s medical record (or common hospital record in a hospital, long-term care institution or multi-specialty clinic).

The request must identify the consultant by name and/or specialty, the referring physician, nurse practitioner or dental surgeon by name and billing number, and the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

The consultant must prepare a written report (including findings, opinions, and recommendations) and send it to the referring provider.

Usage limits

Limited to one service per patient per two consecutive 12-month periods for the same diagnosis by the same physician, except for repeat consultations or specific hospital inpatient exceptions.

A155Consultation - Endocrinology & Metabolism (Office/Out-patient)W155Consultation - Endocrinology & Metabolism (Long-Term Care)C760Complex endocrine neoplastic disease assessment K045Diabetes management by a specialist A155 W155 C760 K045 C150 C255 C156 C153 C154 C151 W150 W255 W156 W760

If the consultant has previously assessed the patient for the same presenting illness within 90 days of the admission, the admission assessment may be adjusted to a reassessment fee (e.g., C154).

Age-based premiums: <30 days (30%), 30 days to <1 year (25%), 1 year to <2 years (20%), 2 years to <5 years (15%), 5 years to <16 years (10%).

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