What is OHIP billing code C463?

C463 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C463 pay?

The current OHIP fee for C463 is $107.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C463 to OHIP?

C463 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C463 claims against the Schedule of Benefits rules before submission.

What codes are related to C463?

Codes related to C463 in the Schedule of Benefits include A465, A765, A460, A275, A466, A463, A464, A461.

All codes

C463

C463 – Medical specific 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
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(this code)
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 medical specific assessment rendered by an Infectious Disease (46) specialist for a non-emergency hospital in-patient. A medical specific assessment 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. The 'C' prefix indicates the service is for a non-emergency hospital in-patient (, ).

A direct physical encounter with the patient is required, including taking a patient history and performing a physical examination ().

The record must document a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) ().

A465 A765 A460 A275 A466 A463 A464 A461 A468 E078 C465 C765 C460 C275 C466 C464 C461 C463 C270 A270

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