What is OHIP billing code C413?

C413 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C413 pay?

The current OHIP fee for C413 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C413 to OHIP?

C413 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C413 claims against the Schedule of Benefits rules before submission.

What codes are related to C413?

Codes related to C413 in the Schedule of Benefits include A413, C418, A418, C414, A414.

All codes

C413

C413 – Medical specific assessment

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

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Levels of this visit

The C41x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C414 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist and requires a full, relevant history and physical examination of one or more systems.
$72.00
C411 Complex medical specific re-assessment
Complex medical specific re-assessment for a non-emergency hospital in-patient, listed under Gastroenterology (41) Non-Emergency Hospital In-Patient Services.
$83.40
C413 Medical specific assessment(this code)
C413 is a medical specific assessment rendered by a specialist in Gastroenterology (specialty 41) for a non-emergency acute care hospital in-patient, as designated by the 'C'…
$95.95

Consultations

C416 Repeat consultation
Repeat consultation for a non-emergency hospital in-patient, listed under Gastroenterology (41) Non-Emergency Hospital In-Patient Services.
$106.90
C415 Consultation
A consultation is an assessment rendered by a specialist in Gastroenterology for a hospital in-patient following a written request from a referring physician, nurse practitioner…
$159.45

`C413` is a medical specific assessment rendered by a specialist in Gastroenterology (specialty 41) for a non-emergency acute care hospital in-patient, as designated by the 'C' prefix . As per , this service requires a full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function. In addition to the common elements, it includes all specific elements of assessments outlined in , such as a direct physical encounter, making arrangements for related procedures and follow-up care, and discussing findings with the patient.

A413 C418 A418 C414 A414

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