C945 – Special palliative care consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A special palliative care consultation provided in a non-emergency, acute care hospital in-patient setting. This service requires a written referral from a physician, nurse practitioner, or dental surgeon for a terminally ill patient in the final year of life where the decision has been made to forgo aggressive treatment of the underlying disease. The service is subject to the same conditions as fee code A945. As a consultation, it requires a comprehensive assessment of the patient, a review of all relevant data, and the preparation of a written report to the referring practitioner. See for full consultation requirements.
When to Use
- Use C945 for an initial inpatient consultation for a terminally ill patient where the primary goal of care has shifted to comfort measures and the patient is within the final year of life.
- Use this code when a formal written referral is received from another physician or nurse practitioner to provide specialized palliative expertise for a patient who is no longer pursuing aggressive curative treatment.
Common Pitfalls
- Billing C945 for patients who are not in the terminal phase of their illness or who are still receiving active, aggressive disease-modifying treatments.
- Attempting to claim a special visit premium with C945; this code is strictly for inpatient settings and must be billed as A945 with the appropriate premium if a special visit is required.
- Failing to maintain a formal, written referral in the patient's chart, which is a mandatory requirement for all consultation codes under GP16.
Billing Tips
- If your assessment exceeds 50 minutes, you may bill K023 in addition to C945, ensuring that the time claimed for K023 begins only after the initial 50 minutes of the consultation have elapsed.
- Ensure the written report to the referring practitioner clearly documents the transition to comfort-directed care to justify the use of the palliative-specific code over a standard internal medicine or general consultation code.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
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. In a hospital where common medical records are maintained, the written request may be contained on the common medical record.
The request identifies the consultant by name, 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.
The consultant must prepare a written report including findings, opinions, and recommendations to the referring practitioner.
subject to the same conditions as A945
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