What is OHIP billing code C481?

C481 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C481 pay?

The current OHIP fee for C481 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C481 to OHIP?

C481 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C481 claims against the Schedule of Benefits rules before submission.

What codes are related to C481?

Codes related to C481 in the Schedule of Benefits include C485, C765, C590, C595, C486, C483, C484, C480.

All codes

C481

C481 – 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 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(this code)
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
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 medical specific re-assessment rendered by a Rheumatologist for a non-emergency hospital in-patient. According to , this service 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. The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician, otherwise the amount payable will be adjusted to a lesser assessment fee. The 'C' prefix indicates the service is for a non-emergency in-patient in an acute care hospital ().

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

All insured services must be documented in appropriate medical records to establish that the service was provided, is the service for which the account is submitted, and was medically necessary. ()

The medical record must contain the patient's name and health number, the date and reason for the service, and the opinion, diagnosis, advice, and/or recommendations of the specialist. ()

For services involving time, the start and end times must be recorded in the patient's medical record. ()

The patient's permanent medical record must identify the supervising physician, the medical trainee and their level of training, the description of the service, and patient consent if performed by a medical trainee under supervision. ()

C485 C765 C590 C595 C486 C483 C484 C480 C482 C487 C489 C121 C488 C982

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