What is OHIP billing code C480?

C480 is "Complex rheumatology assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C480 pay?

The current OHIP fee for C480 is $112.00, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C480 to OHIP?

C480 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C480 claims against the Schedule of Benefits rules before submission.

What codes are related to C480?

Codes related to C480 in the Schedule of Benefits include A480.

All codes

C480

C480 – Complex rheumatology assessment

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

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Levels of this visit

The C48x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C484 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist to a non-emergency hospital in-patient.
$72.00
C481 Complex medical specific re-assessment
A complex medical specific re-assessment rendered by a Rheumatologist for a non-emergency hospital in-patient.
$83.40
C483 Medical specific assessment
A medical specific assessment is a service rendered by a specialist for a non-emergency hospital in-patient.
$95.95
C480 Complex rheumatology assessment(this code)
A complex rheumatology assessment rendered to a non-emergency hospital in-patient by a specialist in Rheumatology.
$112.00

Consultations

C486 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…
$124.50
C485 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon in connection with an insured dental…
$201.95

A complex rheumatology assessment rendered to a non-emergency hospital in-patient by a specialist in Rheumatology. This service is subject to the same conditions as an out-patient Complex Rheumatology Assessment (A480). As an assessment, it includes the specific elements outlined in the Schedule of Benefits, such as a direct physical encounter, patient history, physical examination, and arranging for any related care or follow-up as described in . This service is governed by the rules for non-emergency in-patient services found in to .

A complex rheumatology assessment is an assessment for the ongoing management of the following diseases of the musculoskeletal system where the complexity of the condition requires the continuing management by a rheumatologist: Systemic vasculitides; Inflammatory myopathies; Polymyalgia rheumatica; or Paediatric vasculitides.

Must include the elements of a medical specific re-assessment, or the amount payable will be adjusted to lesser assessment fee.

Usage limits

OR([1, "12_months", "per_patient_per_physician", "General rules for specific assessments limit them to one per patient per physician per 12-month period, unless the patient presents a second time with a complaint for which a clearly different diagnosis is made"], [2, "12_months", "per_patient_per_physician", "In the case of a medical specific assessment, at least 90 days have elapsed and the second assessment is a hospital admission assessment, the limit is two per 12-month period. See ."])

A480

subject to the same conditions as A480

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