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C161 – Complex medical specific re-assessment

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

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(this code)

    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

    A comprehensive nephrology consultation is a service rendered by a specialist in nephrology for a hospital in-patient.

    $342.25
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. It includes all the requirements of a medical specific re-assessment, which requires a full, relevant history and physical examination of one or more systems.
The physician must report his/her findings, opinions, or recommendations in writing to the patient’s primary care physician.
Requires a full, relevant history and physical examination of one or more systems.
Usage limits
Limited to 4 per patient per physician per 12 month period. This limit is shared with medical specific assessments (C163).

The amount payable for services in excess of the 12-month limit will be adjusted to a lesser assessment fee.

If the required written report to the primary care physician is not provided, the amount payable will be adjusted to a lesser assessment fee.

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