What is OHIP billing code C465?

C465 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C465 pay?

The current OHIP fee for C465 is $205.90, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C465 to OHIP?

C465 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C465 claims against the Schedule of Benefits rules before submission.

What codes are related to C465?

Codes related to C465 in the Schedule of Benefits include A465, C765, A765, A460, C460, C275, C466, C463.

All codes

C465

C465 – Consultation

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
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(this code)
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 consultation service rendered by a specialist in Infectious Disease (46) for a non-emergency hospital in-patient. A consultation requires a written request from a referring practitioner and is performed due to the complexity, seriousness, or obscurity of the case. The service includes a full assessment of the patient and a written report of findings and recommendations back to the referring practitioner. This service must adhere to all requirements for consultations as outlined in the General Preamble, starting on page .

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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

The written request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.

The consultant must prepare a written report including findings, opinions, and recommendations to the referring practitioner.

Usage limits

OR([1, "24_months", "per_patient_per_physician", "Limited to one service for the same diagnosis per two consecutive 12-month periods."], [2, "24_months", "per_patient_per_physician", "A second consultation for the same diagnosis is payable if it occurs more than 12 months but less than 24 months after the first, and the patient is a hospital inpatient or in an Emergency Department."], [1, "12_months", "per_patient_per_physician", "Limited to one service for a clearly defined unrelated diagnosis."])

A465 C765 A765 A460 C460 C275 C466 C463 C464 C461

See General Preamble to for rules on Non-Emergency Hospital In-patient Services.

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .

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