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C724

C724Medical specific re-assessment

OHIP Surgical Procedures Code · Schedule of Benefits

Medical specific re-assessment (Occupational Medicine)

When to Use

  • Use C724 when you are the admitting physician but have already assessed the patient for the same illness within the previous 90 days, making a full consultation (C725) ineligible.
  • Use C724 for the initial hospital admission assessment when you have an existing longitudinal relationship with the patient for the current condition, as this precludes billing a new consultation.
  • Use C724 as the primary code when performing a hospital admission assessment that does not meet the complexity requirements for C721.

Common Pitfalls

  • Billing C725 (Consultation) instead of C724 when a prior assessment for the same illness occurred within 90 days, which will trigger a rejection or audit recovery.
  • Attempting to bill C724 on the same day as other assessment codes (e.g., C722) for the same patient, which violates the same-day billing restriction.
  • Failing to recognize that E082 is only applicable when you are the Most Responsible Physician (MRP) performing the admission assessment; billing E082 as a non-MRP will lead to claim rejection.

Billing Tips

  • If you are the MRP and performing the admission assessment, always append the E082 premium to C724 to maximize the value of the admission service.
  • If the patient's condition is highly complex and requires a formal written report to the referring physician, bill C721 instead of C724 to capture the higher fee associated with complex re-assessments.
Provider Fee$0.00
Specialist Fee$72.00

Effective: April 1, 2026

Service Type

Hospital In-Patient

Code Classes

Assessment

Requires a full, relevant history and physical examination of one or more systems.

If billed as an admission assessment, it must be the initial assessment for the purpose of admitting the patient to the hospital.

If the admitting physician has previously assessed the patient for the same illness within 90 days, the admission assessment must be billed as a re-assessment (C724) rather than a consultation or specific assessment.

Admission assessments are deemed to be a medical specific re-assessment if the physician has assessed the patient prior to admission in respect of the same illness ().

If the physician is not the MRP but is asked to perform the admission assessment, C724 may still be billed but E082 would not apply.

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