What is OHIP billing code C461?

C461 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C461 pay?

The current OHIP fee for C461 is $95.05, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C461 to OHIP?

C461 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C461 claims against the Schedule of Benefits rules before submission.

What codes are related to C461?

Codes related to C461 in the Schedule of Benefits include A461, A463, C463, C464.

All codes

C461

C461 – Complex medical specific re-assessment

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

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Levels of this visit

The C46x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C464 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist for a non-emergency hospital in-patient.
$82.10
C461 Complex medical specific re-assessment(this code)
A complex medical specific re-assessment rendered by a specialist in Infectious Disease (46) for a non-emergency hospital in-patient.
$95.05
C463 Medical specific assessment
A medical specific assessment rendered by an Infectious Disease (46) specialist for a non-emergency hospital in-patient.
$107.00

Consultations

C466 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another…
$124.00
C465 Consultation
A consultation service rendered by a specialist in Infectious Disease (46) for a non-emergency hospital in-patient.
$205.90
C460 Comprehensive infectious disease consultation
A comprehensive infectious disease consultation rendered to a non-emergency hospital in-patient by a specialist in infectious disease.
$342.25

A complex medical specific re-assessment rendered by a specialist in Infectious Disease (46) for a non-emergency hospital in-patient. This service is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient's condition and includes all the requirements of a medical specific re-assessment as outlined in the Schedule. The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician. If this report is not provided, the amount payable for the service will be adjusted to a lesser assessment fee.

The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician or the amount payable for the service will be adjusted to a lesser assessment fee.

A461 A463 C463 C464

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