What is OHIP billing code C160?

C160 is "Comprehensive nephrology consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C160 pay?

The current OHIP fee for C160 is $342.25, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C160 to OHIP?

C160 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C160 claims against the Schedule of Benefits rules before submission.

What codes are related to C160?

Codes related to C160 in the Schedule of Benefits include A160, W160, C165, C865, C166.

All codes

C160

C160 – Comprehensive nephrology consultation

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

Ask a question

Levels of this visit

The C16x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C164 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist to a non-emergency hospital in-patient.
$72.00
C161 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
C163 Medical specific assessment
A medical specific assessment rendered by a Nephrology specialist for a non-emergency hospital in-patient.
$95.95

Consultations

C166 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…
$116.75
C165 Consultation
A consultation rendered by a nephrologist for a non-emergency hospital in-patient, aged 17 years or older.
$180.75
C160 Comprehensive nephrology consultation(this code)
A comprehensive nephrology consultation is a service rendered by a specialist in nephrology for a hospital in-patient.
$342.25

A comprehensive nephrology consultation is a service rendered by a specialist in nephrology for a hospital in-patient. It requires the physician to provide all appropriate elements of a consultation and spend a minimum of seventy-five (75) minutes of direct contact with the patient, exclusive of time spent rendering any other separately billable intervention or non-patient-facing time (e.g., chart review).

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Must follow a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).

Requires a written report (findings, opinions, and recommendations) to the referring provider.

Minimum of 75 minutes of direct contact with the patient is required.

Start and stop times must be recorded in the patient's permanent medical record.

Calculation of time excludes time devoted to any other service or procedure for which an amount is payable in addition to the consultation.

Calculation of time excludes non-patient-facing time such as reviewing charts, imaging, or documentation.

Usage limits

Limited to one service per two consecutive 12-month periods for the same diagnosis (subject to general consultation limit exceptions for hospital in-patients). Consultations for a clearly defined unrelated diagnosis are limited to one service every 12 months.

A160Comprehensive nephrology consultation (Outpatient/General)W160Comprehensive nephrology consultation (Long-Term Care)C165Nephrology Consultation (Standard)C865Nephrology Limited consultation C166Nephrology Repeat consultation

Subject to the same conditions as A160 (the outpatient comprehensive nephrology consultation).

Eligible for age-based fee premiums () for patients under 16 years of age.

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