What is OHIP billing code C164?

C164 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C164 pay?

The current OHIP fee for C164 is $72.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C164 to OHIP?

C164 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C164 claims against the Schedule of Benefits rules before submission.

All codes

C164

C164 – Medical specific re-assessment

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

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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(this code)
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
A comprehensive nephrology consultation is a service rendered by a specialist in nephrology for a hospital in-patient.
$342.25

A medical specific re-assessment is a service rendered by a specialist to a non-emergency hospital in-patient. It requires a full, relevant history and physical examination of one or more systems, as defined in . It includes all the specific elements of an assessment listed in (e.g., history, physical examination, arranging follow-up) and the common elements of all insured services (-). This code is used for services provided in an acute care hospital for non-emergency in-patients (). This service may constitute a hospital admission assessment if the physician has previously assessed the patient for the same presenting illness within 90 days of the admission ().

Requires documentation of a full, relevant history and physical examination of one or more systems.

All insured services must be documented in the medical record to establish that the service was provided, was medically necessary, and matches the service claimed ().

The medical record must include all specific elements of an assessment as defined in .

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