What is OHIP billing code C485?

C485 is "Consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C485 pay?

The current OHIP fee for C485 is $201.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C485 to OHIP?

C485 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C485 claims against the Schedule of Benefits rules before submission.

What codes are related to C485?

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

All codes

C485

C485 – Consultation

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
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(this code)
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 consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon in connection with an insured dental procedure rendered in a hospital, who, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician”) competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient’s representative. A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable. Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

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, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.

The request identifies the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.

The written request sets out the information relevant to the referral and specifies the service(s) required.

A written report (including findings, opinions, and recommendations) must be prepared and sent to the referring physician, nurse practitioner or dental surgeon.

C765 C590 C595 C486 C483 C484 C481 C480 C482 C487 C489 C122 C123 C124 C142 C143 C121 C488 C982 A485 C126

Consultation limits apply to all consultation types, including time-based and age-specific services, but not repeat consultations.

A preoperative consultation for low-risk elective surgeries (e.g., cataract surgery, colonoscopy) is only payable if the medical record demonstrates it is medically necessary, which is considered very uncommon.

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