What is OHIP billing code C471?

C471 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C471 pay?

The current OHIP fee for C471 is $86.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C471 to OHIP?

C471 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C471 claims against the Schedule of Benefits rules before submission.

What codes are related to C471?

Codes related to C471 in the Schedule of Benefits include C473, C475, C765, C470, C575, C476, C570, C472.

All codes

C471

C471 – 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 C47x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C474 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist for a hospital in-patient.
$72.80
C471 Complex medical specific re-assessment(this code)
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient's condition and includes all the…
$86.40
C473 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in a hospital in-patient setting.
$99.15

Consultations

C476 Repeat consultation
C476 is a repeat consultation provided by a specialist in Respiratory Disease (47).
$115.30
C475 Consultation
A consultation is an assessment rendered to a non-emergency hospital in-patient following a written request from a referring physician, nurse practitioner, or dental surgeon.
$185.80
C470 Comprehensive respiratory disease consultation
A comprehensive respiratory disease consultation for a patient in a non-emergency hospital in-patient setting.
$342.25

A complex medical specific re-assessment 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 defined in the Schedule of Benefits (), a medical specific re-assessment requires a full, relevant history and physical examination of one or more systems. 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 (). The 'C' prefix indicates this service is for non-emergency hospital in-patients ().

The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician.

As an assessment, this service requires documentation of a direct physical encounter with the patient, including a patient history and physical examination.

The medical record must contain all required information to establish that an insured service was provided, was medically necessary, and is the service for which the account is submitted.

Usage limits

OR([4, "12_months", "per_patient_per_physician", "Limited to 4 complex medical specific re-assessments per patient per physician per 12-month period."], [4, "12_months", "per_patient_per_physician", "Included in a combined limit of 4 services per patient per physician per 12-month period with medical specific assessments (e.g., C473)."])

C473 C475 C765 C470 C575 C476 C570 C472 C477 C479 C122 C123 C124 C142 C143 C121 C478 C982

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