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By practice setting
Hospital in-patient OHIP billing codes
Admissions, subsequent visits, MRP premiums and hospital special-visit premiums for physicians rounding on admitted patients.
26 codes in 6 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 00 is in the full Family Practice listing.
Admission & assessments
- C003General assessmentGeneral assessment (hospital in-patient)$89.65
- C004General re-assessmentGeneral re-assessment (Hospital In-patient)$38.35
- C933On-call admission assessmentAn on-call admission assessment by a family or general practitioner for a non-emergency hospital in-patient, subject to the same conditions as billing code <billingCode>A933</billingCode>.$82.00
- C777Intermediate assessment - Pronouncement of deathAn intermediate assessment for the pronouncement of death of a non-emergency hospital in-patient. This service includes any counselling of relatives during the same visit and completion of the death certificate.$44.55
Subsequent visits
- C122Subsequent visit by the MRP - day following hospital admission assessment$71.80
- C123Second day following the hospital assessmentSubsequent visit by the MRP – second day following the hospital admission assessment$71.80
- C124Subsequent visit - day of dischargeSubsequent visit by the Most Responsible Physician (MRP) on the day of discharge from hospital.$71.80
- C142First subsequent visit by the MRP following transfer from an Intensive Care Area The first subsequent visit performed by the Most Responsible Physician (MRP) for a patient following their transfer from an Intensive Care Area (ICU) to an acute care hospital bed within the same hospital. $71.80
- C143Second subsequent visit by the MRP following transfer from an Intensive Care Area$71.80
- C002Subsequent visit - first five weeksA routine assessment rendered to a hospital in-patient during the first five weeks following admission. This service is limited to one per patient, per day.$40.05
- C007Subsequent visit - sixth to thirteenth week inclusive$40.05
- C009Subsequent visit - after thirteenth week$40.05
- C882Palliative careA palliative care visit rendered by the Most Responsible Physician (MRP) to a patient in a designated palliative care bed.$40.05
Phone consults & CritiCall
- K734Physician to physician telephone consultation - Referring physicianA telephone consultation initiated by a referring physician or nurse practitioner, who is on duty in an emergency department or hospital urgent care clinic, to request the opinion of a consultant physician due to the complexity, seriousness, or obscurity of a patient's case.$37.05
- K735Physician to physician telephone consultation - Consultant physicianPayable to a consultant physician on duty in an emergency department or hospital urgent care clinic for providing a telephone consultation to a referring physician or nurse practitioner, requested due to the complexity, seriousness, or obscurity of a case.$47.75
- K736CritiCall telephone consultation - Referring physicianA telephone consultation arranged via CritiCall by a referring physician or nurse practitioner who is on duty in an emergency department or hospital urgent care clinic to obtain advice from a consultant physician.$37.05
- K737CritiCall telephone consultation - Consultant physicianA telephone consultation provided by a consultant physician on duty in an emergency department or hospital urgent care clinic, arranged by CritiCall Ontario, to advise a referring provider on patient management.$47.75
Forms & certificates
How to use this hospital code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to family practice and practice in general (specialty 00) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a hospital physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does hospital in-patient bill?
The admission & assessments section of this set starts with C003 (General assessment), which pays $89.65 under the current Ontario Schedule of Benefits. 4 codes are listed in that section.
What is in the Hospital in-patient code set?
26 OHIP billing codes across 6 sections: Admission & assessments; Subsequent visits; MRP premiums; Special visit premiums — hospital in-patient (first person seen); Phone consults & CritiCall; Forms & certificates. Admissions, subsequent visits, MRP premiums and hospital special-visit premiums for physicians rounding on admitted patients.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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