What is OHIP billing code C623?

C623 is "Medical specific assessment", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C623 pay?

The current OHIP fee for C623 is $95.95, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C623 to OHIP?

C623 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C623 claims against the Schedule of Benefits rules before submission.

What codes are related to C623?

Codes related to C623 in the Schedule of Benefits include A623, C625, A625, C626, A626, C624, A624, C621.

All codes

C623

C623 – Medical specific assessment

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

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Levels of this visit

The C62x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C624 Medical specific re-assessment
C624 is a medical specific re-assessment rendered by a Clinical Immunology specialist (specialty 62) for a non-emergency hospital in-patient.
$72.00
C621 Complex medical specific re-assessment
A complex medical specific re-assessment is a service rendered to a non-emergency hospital in-patient by a Clinical Immunology specialist.
$83.40
C623 Medical specific assessment(this code)
A medical specific assessment rendered by a Clinical Immunology specialist (specialty 62) for a non-emergency hospital in-patient.
$95.95

Consultations

C626 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care rendered to the patient by another physician in…
$105.25
C625 Consultation
A consultation rendered by a Clinical Immunology (62) specialist for a non-emergency hospital in-patient.
$160.30

A medical specific assessment rendered by a Clinical Immunology specialist (specialty 62) for a non-emergency hospital in-patient. As per the Schedule, a medical specific assessment requires a detailed history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) to make a diagnosis, exclude disease, or assess function. This service includes all the specific elements of assessments described in and common elements detailed in -.

A full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function must be documented in the patient's medical record. (from )

All insured services must be documented in the patient's medical record to establish that the service was provided, medically necessary, and matches the service claimed. (from )

Usage limits

OR([1, "12_months", "per_patient_per_physician", "Maximum of one per 12 month period."], [2, "12_months", "per_patient_per_physician", "Maximum of two per 12 month period if the patient presents with a clearly different and unrelated diagnosis, or if the second assessment is a hospital admission assessment at least 90 days after the last."], [4, "12_months", "per_patient_per_physician", "A combination of medical specific assessments and complex medical specific re-assessments is limited to 4 per patient per physician per 12 month period."])

A623 C625 A625 C626 A626 C624 A624 C621 A621 A628 A525 C525

See General Preamble to for terms and conditions.

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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