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C625 – Consultation

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

    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(this code)

    A consultation rendered by a Clinical Immunology (62) specialist for a non-emergency hospital in-patient.

    $160.30
A consultation rendered by a Clinical Immunology (62) specialist for a non-emergency hospital in-patient. A consultation is defined in () as an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure in a hospital). The consultant's opinion is sought because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or their representative. The service requires the consultant to perform a general, specific or medical specific assessment, including a review of all relevant data, and to prepare a written report with findings, opinions, and recommendations for the referring practitioner. This service is for non-emergency acute care hospital in-patient services, as indicated by the 'C' prefix (, ).
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 and/or the specialty being consulted, 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 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.
Usage limits
OR([1, "24_months", "per_patient_per_physician", "For the same diagnosis. Limit is one service per two consecutive 12 month periods. An exception allows a second service if it is for a hospital inpatient or ED patient and is rendered more than 12 but less than 24 months after the first."], [1, "12_months", "per_patient_per_physician", "For a clearly defined unrelated diagnosis. Limit is one service every 12 months."])
A625C765C525C626A623A624A621A628C623C624C621C122C123C124C126

For Services not listed, refer to Internal Medicine Section.

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