What is OHIP billing code C464?

C464 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C464 pay?

The current OHIP fee for C464 is $82.10, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C464 to OHIP?

C464 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C464 claims against the Schedule of Benefits rules before submission.

What codes are related to C464?

Codes related to C464 in the Schedule of Benefits include A464.

All codes

C464

C464 – 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(this code)
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
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 re-assessment is a service rendered by a specialist for a non-emergency hospital in-patient. As per , it is a service rendered by specialists and requires a full, relevant history and physical examination of one or more systems. It includes all the services listed for a general assessment, with the exception of the patient's history, which need not include all the details already obtained in the original assessment. This service also includes the specific elements of assessments outlined in and the common elements of all insured services outlined in and . When an admitting physician has previously assessed the patient for the same presenting illness within 90 days of the admission assessment, this service may constitute the admission assessment as per .

A service is only eligible for payment to the Supervising Physician when the medical record of the patient(s) identifies the Supervising Physician, the Medical Trainee and level of training, the description of the insured service performed by the Medical Trainee, and patient consent to the Supervision of services of a Medical Trainee. The Supervising Physician must have signed off on the service rendered or the Medical Trainee has documented the date and time of discussion with the Supervising Physician ().

The medical record must contain a full, relevant history and physical examination of one or more systems ().

Usage limits

OR([2, "12_months", "per_patient_per_physician", "Medical specific re-assessments are generally limited to two per patient per physician per 12-month period"], [1, "per_admission", "per_patient_per_physician", "this limit does not apply to re-assessments rendered for hospital admissions"])

A464

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