What is OHIP billing code C473?

C473 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C473 pay?

The current OHIP fee for C473 is $99.15, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C473 to OHIP?

C473 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C473 claims against the Schedule of Benefits rules before submission.

What codes are related to C473?

Codes related to C473 in the Schedule of Benefits include A473, C475, C765, C470, C575, C476, C474, C471.

All codes

C473

C473 – Medical specific assessment

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

Ask a question

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
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(this code)
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 medical specific assessment is a service rendered by a specialist in a hospital in-patient setting. It requires a full history of the presenting complaint and a 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. As a 'C' prefix code, this service is for non-emergency hospital in-patient services.

A direct physical encounter with the patient including taking a patient history and performing a physical examination.

Other inquiry (including taking a patient history), carried out to arrive at an opinion as to the nature of the patient's condition, (whether such inquiry takes place before, during or after the encounter during which the physical examination takes place) and/or follow-up care.

Discussion with, and providing advice and information, including prescribing therapy to the patient or the patient's representative, whether by telephone or otherwise.

When medically indicated, monitoring the condition of the patient and intervening, until the next insured service is provided.

Usage limits

OR([1, "12_months", "per_patient_per_physician", "Limited to one per 12 month period. Limit increases to two if the patient presents with a clearly different and unrelated diagnosis, or if at least 90 days have elapsed and the second assessment is for hospital admission."], [4, "12_months", "per_patient_per_physician", "Any combination of medical specific assessments and complex medical specific re-assessments are limited to 4 per patient per physician per 12 month period."])

A473 C475 C765 C470 C575 C476 C474 C471 C570

The 'C' prefix indicates a service rendered as a non-emergency hospital in-patient service.

For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable.

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in