What is OHIP billing code C415?

C415 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C415 pay?

The current OHIP fee for C415 is $159.45, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C415 to OHIP?

C415 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C415 claims against the Schedule of Benefits rules before submission.

What codes are related to C415?

Codes related to C415 in the Schedule of Benefits include A415, C410, C413, C414, C416, C418, C545, C411.

All codes

C415

C415 – Consultation

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
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(this code)
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

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, or a dental surgeon (for an in-hospital dental procedure). The request is made due to the complexity, seriousness, or obscurity of the case, or at the request of the patient or their representative. The service includes all necessary steps for the consultant to provide a written report with findings, opinions, and recommendations to the referring practitioner. A full assessment, including a review of all relevant data, is required. The 'C' prefix indicates the service is for a non-emergency in-patient in an acute care hospital as per .

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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

A415 C410 C413 C414 C416 C418 C545 C411

Consultation limits apply to all consultations, including time-based and age-specific consultation services, but not repeat consultations.

In the preoperative preparation of a patient undergoing specific low risk elective surgical procedures (e.g., cataract surgery, colonoscopy), a preoperative consultation is only eligible for payment where the medical record demonstrates it is medically necessary.

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