What is OHIP billing code C285?

C285 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C285 pay?

The current OHIP fee for C285 is $163.00, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill C285 to OHIP?

C285 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C285 claims against the Schedule of Benefits rules before submission.

What codes are related to C285?

Codes related to C285 in the Schedule of Benefits include A285, C286, C586, C283, C585, C288, C580.

All codes

C285

C285 – Consultation

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

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Levels of this visit

The C28x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C283 Medical specific assessment
A medical specific assessment is a service rendered by a specialist that requires a full history of the presenting complaint and a detailed examination of the affected part(s)…
$82.50

Consultations

C286 Limited consultation
A limited consultation is an assessment which is less demanding and, in terms of time, normally requires substantially less of the physician's time than a full consultation (C285).
$108.95
C285 Consultation(this code)
A consultation is an assessment rendered for a non-emergency hospital in-patient following a written request from a referring physician, nurse practitioner, or dental surgeon (in…
$163.00

A consultation is an assessment rendered for a non-emergency hospital in-patient following a written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure rendered in a hospital). The request is made because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient. The service is rendered by a specialist in Laboratory Medicine (28), which includes Haematopathology, Neuropathology, Medical Biochemistry, Medical Microbiology, Anatomic and General Pathology. It includes all services necessary to prepare a written report with findings, opinions, and recommendations for the referring practitioner. A copy of the written request must be kept in the medical record. If the requirements are not met, the service may be paid as a lesser assessment.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

Usage limits

OR([1, "24_months", "per_patient_per_physician", "Consultations rendered to the same patient by the same physician for the same diagnosis are limited to one service per two consecutive 12 month periods except when the additional consultation service(s) is a repeat consultation"], [2, "24_months", "per_patient_per_physician", "When a consultant has rendered a consultation service to a patient in any location and the same consultant is referred to the same patient a second time with the same diagnosis, then the number of consultations eligible for payment is a total of two services per two consecutive 12 month periods only when the second consultation is rendered for a hospital inpatient or a patient in an Emergency Department and the consultation is rendered more than 12 months but less than 24 months following the first consultation"], [1, "12_months", "per_patient_per_physician", "Consultations rendered to the same patient by the same consultant with a clearly defined unrelated diagnosis are limited to one service every 12 months"])

A285 C286 C586 C283 C585 C288 C580

The 'C' prefix indicates this service is for non-emergency hospital in-patient services.

See General Preamble to for rules on Hospital and Institutional Consultations and Assessments.

For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable - see General Preamble to .

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