What is OHIP billing code C223?

C223 is "Extended special genetic consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C223 pay?

The current OHIP fee for C223 is $442.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C223 to OHIP?

C223 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C223 claims against the Schedule of Benefits rules before submission.

All codes

C223

C223 – Extended special genetic consultation

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

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Levels of this visit

The C22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

C226 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care rendered to the patient by another physician in…
$119.40
C225 Consultation
A consultation rendered by a specialist in Genetics (specialty 22) for a non-emergency acute care hospital in-patient.
$190.50
C220 Special genetic consultation
A special genetic consultation provided for a non-emergency hospital in-patient.
$342.25
C223 Extended special genetic consultation(this code)
An extended special genetic consultation for a non-emergency hospital in-patient.
$442.40

An extended special genetic consultation for a non-emergency hospital in-patient. This service is subject to the same conditions as A223. As a 'C' prefix code, this service is rendered in an acute care hospital for a non-emergency in-patient. A consultation requires a written request from a referring practitioner and a written report of findings and recommendations must be sent back. The 'extended special' nature implies it is more demanding and time-consuming than a standard consultation, and the physician spends a minimum of 90 minutes in direct contact with the patient with or without family, exclusive of time spent rendering any other separately billable intervention to the patient.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician's medical record. In a hospital where common medical records are maintained, the written request may be contained on the common medical record.

The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.

The written request must set out the information relevant to the referral and specify the service(s) required.

A written report including findings, opinions, and recommendations must be sent to the referring practitioner.

A consultation is payable at nil if a genetic assessment (K016) or genetic care (K222) has previously been claimed by the same physician.

Subject to the same conditions as A223.

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