What is OHIP billing code C225?

C225 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C225 pay?

The current OHIP fee for C225 is $190.50, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C225 to OHIP?

C225 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C225 claims against the Schedule of Benefits rules before submission.

What codes are related to C225?

Codes related to C225 in the Schedule of Benefits include A225, C220, C223, C325, C226, C800, C801, C802.

All codes

C225

C225 – 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(this code)
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
An extended special genetic consultation for a non-emergency hospital in-patient.
$442.40

A consultation rendered by a specialist in Genetics (specialty 22) for a non-emergency acute care hospital in-patient. A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon. It requires a review of all relevant data and preparation of a written report to the referring practitioner. The 'C' prefix designates this service for non-emergency hospital in-patients. For full consultation requirements, see General Preamble through . Note: This service is payable at nil if a genetic assessment (K016) or genetic care (K222) has previously been claimed by the same physician.

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, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.

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

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

A written report (including findings, opinions, and recommendations) must be prepared and delivered to the referring physician, nurse practitioner or dental surgeon.

A225 C220 C223 C325 C226 C800 C801 C802 W225 K016 K222

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

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