What is OHIP billing code C604?

C604 is "Medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C604 pay?

The current OHIP fee for C604 is $72.65, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C604 to OHIP?

C604 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C604 claims against the Schedule of Benefits rules before submission.

What codes are related to C604?

Codes related to C604 in the Schedule of Benefits include C605, C765, C600, C675, C606, C603, C601, C602.

All codes

C604

C604 – Medical specific re-assessment

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

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Levels of this visit

The C60x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C604 Medical specific re-assessment(this code)
A medical specific re-assessment rendered by a specialist in Cardiology (specialty 60) for a non-emergency acute care hospital in-patient.
$72.65
C601 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…
$84.10
C603 Medical specific assessment
A medical specific assessment rendered by a specialist in Cardiology (60) for a non-emergency hospital in-patient.
$96.70

Consultations

C606 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…
$105.25
C605 Consultation
A consultation is an assessment rendered in an acute care hospital for a non-emergency in-patient following a written request from a referring physician, nurse practitioner, or…
$188.45
C600 Comprehensive cardiology consultation
A comprehensive cardiology consultation for a non-emergency hospital in-patient, subject to the same conditions as A600.
$342.25

A medical specific re-assessment rendered by a specialist in Cardiology (specialty 60) for a non-emergency acute care hospital in-patient. According to , this service requires a full, relevant history and physical examination of one or more part(s), region(s), or system(s). 'C' prefix codes are designated for non-emergency in-patient services in an acute care hospital, as specified in . The service includes all the specific elements of an assessment () and the common elements of all insured services (, ).

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

OHIP diagnostic codes: 428

C605 C765 C600 C675 C606 C603 C601 C602 C607 C609 C122 C123 C124 C142 C143 C121 C608 C982 C604 C126

Claims submission instructions: Submit claims with diagnostic code 428.

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