What is OHIP billing code C611?

C611 is "Complex medical specific re-assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C611 pay?

The current OHIP fee for C611 is $83.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C611 to OHIP?

C611 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C611 claims against the Schedule of Benefits rules before submission.

What codes are related to C611?

Codes related to C611 in the Schedule of Benefits include A611, C614.

All codes

C611

C611 – 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 C61x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C614 Medical specific re-assessment
A medical specific re-assessment rendered by a specialist in Haematology (61) to a patient in an acute care hospital as a non-emergency in-patient service.
$72.00
C611 Complex medical specific re-assessment(this code)
A complex medical specific re-assessment is a re-assessment of a patient by a specialist because of the complexity, obscurity, or seriousness of the patient's condition.
$83.40
C613 Medical specific assessment
A medical specific assessment rendered by a specialist for a non-emergency hospital in-patient.
$95.95

Consultations

C616 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…
$118.05
C615 Consultation
This service is a consultation for a non-emergency acute care hospital in-patient (GP12, A117).
$192.90

A complex medical specific re-assessment is a re-assessment of a patient by a specialist because of the complexity, obscurity, or seriousness of the patient's condition. It includes all the requirements of a medical specific re-assessment, which requires a full, relevant history and physical examination of one or more systems. The service is rendered to a hospital in-patient on a non-emergency basis. As an assessment, it includes the specific elements described in the General Preamble (), which include: a direct physical encounter, history-taking, physical examination, performing non-listed procedures, arranging related assessments or therapy, discussing findings and advice with the patient, and monitoring the patient's condition. The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician; otherwise, the amount payable for the service will be adjusted to a lesser assessment fee.

The physician must report his/her findings, opinions, or recommendations in writing to the patient's primary care physician or the amount payable for the service will be adjusted to a lesser assessment fee.

The medical record must document the complexity, obscurity, or seriousness of the patient's condition justifying the service.

As an assessment, this service includes the specific elements outlined in , including a direct physical encounter, history, examination, and development of an opinion.

A611 C614

For Services not listed, refer to Internal Medicine Section.

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .

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