Fee
| Component | Value |
|---|---|
| Provider fee | $95.10 |
Schedule and sources
- Fee edition
- October 1, 2026
- Record effective
- 2026-04-01
- Schedule edition
- July 22, 2026; effective July 1, 2026
- Official files
- Fee masterSchedule PDFOntario source page
- day of discharge, medically complex patient...................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions .......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions .......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions .......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions .......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions .......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions).......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ........................................................ 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions)....................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
- day of discharge, medically complex patient (see A13 for terms and conditions) ......................................................... 95.10
Passages mentioning C126
Payment rules:
1. C122, C123 are limited to a maximum of one each per hospital admission.
[Commentary:
C122, C123 are only payable for visits rendered by the MRP. Services rendered by physicians
who are not the MRP may be payable at a lesser visit fee.]
2. C122, C123 are not eligible for payment:
a. when rendered to the same patient the same day as C124 or C126 (Subsequent visit by the
MRP - day of discharge); or
b. for a patient admitted for obstetrical delivery or newborn care;
3. When a patient is transferred to another physician within the same hospital during either of
these days, C122 or C123 are only payable to the physician who was the MRP for the majority
of the day.
4. When a patient is transferred to another physician at a different hospital, the day of transfer shall
be deemed for payment purposes to be the day of admission.
5. Only one of C122 or C142 is eligible for payment for the same patient during the same hospital
admission. Only one of C123 or C143 is eligible for payment for the same patient during the
same hospital admission.
[Commentary:
For first and second subsequent visits by the MRP following transfer from an Intensive Care
Area (C142, C143), see General Preamble page GP46.]Payment rules:
1. C142, C143 are limited to a maximum of one each per hospital admission.
[Commentary:
1.C142, C143 are only payable for visits rendered by the MRP. Services rendered by
physicians who are not the MRP may be eligible for payment at a lesser visit fee.
2.C142 or C143 are not eligible for payment for visits rendered to patients who were in an
Intensive Care Area only for monitoring purposes.]
2. C142, C143 are not eligible for payment to the same physician who rendered Critical Care,
Ventilatory Support, Comprehensive Care or Neonatal Intensive Care services prior to the
patient’s transfer.
3. Only one of C122 or C142 is eligible for payment for the same patient during the same hospital
admission. Only one of C123 or C143 is eligible for payment for the same patient during the
same hospital admission.
[Commentary:
For Subsequent visit by the MRP – first and second day following the hospital admission
assessment (C122, C123), see General Preamble page GP44.]
4. C142, C143 are not eligible for payment when rendered to the same patient the same day as
C124 or C126 (Subsequent visit by the MRP – day of discharge)
5. When a patient is transferred to another physician within the same hospital, C142 or C143 are
only payable to the physician who was the MRP for the majority of the day of the transfer.Hospitalist Premium The Hospitalist premium is payable automatically to an eligible physician subject to the definitions and rules described below. Definitions: "Qualifying services" means E082, C122, C123, C124, C126, C002, C007, C009, C132, C137, C139, C142, C143, A/C933, and C882/C982.
Payment rules:
1.In addition to satisfying all of the elements and payment rules of subsequent visit by the MRP
– day of discharge (see page GP45), C126 is only eligible for payment under the following
conditions:
a.the patient has been admitted to hospital for a minimum of 7 consecutive days,
b.the patient has a minimum of three diagnoses that contributed to the length of stay, and
2.The minimum amount of time dedicated to the provision of C126 must be 45 minutes,
exclusive of time spent rendering any other separately billable intervention and personally
rendered by the physician, or the service will be adjusted to a lesser paying fee.
3.Only one of C124 or C126 is eligible for payment per hospital admission.
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C008 Concurrent care .......................................................... per visit 40.05
C010 Supportive care .......................................................... per visit 40.05
C882 Palliative care (see General Preamble GP50)............ per visit 40.05
Attendance at maternal delivery for care of high risk baby(ies)
Attendance at maternal delivery for high risk baby(ies) requires constant attendance at the
delivery of a baby expected to be at risk by a physician who is not a paediatrician, and includes
an assessment of the newborn.
H007 Attendance at maternal delivery for care of high risk baby(ies) 61.65CONSULTATIONS AND VISITS
ANAESTHESIA (01)
Subsequent visits
C012 - first five weeks........................................................ per visit 31.70
C017 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.70
C019 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.70
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions .......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
intensive care area ............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C018 Concurrent care .......................................................... per visit 31.70
C982 Palliative care (see General Preamble GP50)............ per visit 40.05Emergency or Out-Patient Department (OPD)
Physician in hospital but not on duty in the emergency department when seeing patients in the
emergency or OPD - use General Listings.
Non-Emergency Hospital In-Patient Services
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
C605 Consultation............................................................................ 188.45
C600 Comprehensive cardiology consultation - subject to the same
conditions as A600 ............................................................. 342.25
C675 Limited consultation ................................................................ 105.25
C606 Repeat consultation ................................................................ 105.25
C603 Medical specific assessment .................................................. 96.70
C604 Medical specific re-assessment.............................................. 72.65
C601 Complex medical specific re-assessment............................... 84.10
Subsequent visits
C602 - first five weeks ....................................................... per visit 40.05
C607 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C609 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions .......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
intensive care area ............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C608 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
CARDIAC SURGERY (09)
GENERAL LISTINGS
A095 Consultation............................................................................ 113.15
A935 Special surgical consultation (see General Preamble GP19). 194.65
A096 Repeat consultation ................................................................ 75.20
A093 Specific assessment ............................................................... 55.70
A094 Partial assessment ................................................................. 30.35
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the emergency department when seeing patients in the
emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C095 Consultation............................................................................ 113.15
C935 Special surgical consultation (see General Preamble GP19). 194.65
C096 Repeat consultation ................................................................ 75.20
C093 Specific assessment ............................................................... 55.70
C094 Specific re-assessment........................................................... 32.70
Subsequent visits
C092 - first five weeks........................................................ per visit 31.00
C097 - sixth to thirteenth week inclusive (maximum 3 per patient
per week) ............................................................... per visit 31.00
C099 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions .......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
intensive care area ............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C098 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05Subsequent visits
C052 - first five weeks ........................................................ per visit 40.05
C057 - sixth to thirteenth week (maximum 3 per patient per week)
............................................................................... per visit 40.05
C059 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment................... 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions .......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area ............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C058 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05
NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
convalescent care beds in hospitals and nursing homes or homes for the aged, other than
patients in designated palliative care beds. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
W055 Consultation............................................................................ 152.80
W050 Special community medicine consultation – subject to the
same conditions as A050 ................................................... 176.10
W400 Comprehensive community medicine consultation – subject to
the same conditions as A400 ............................................. 270.60
W405 Limited consultation ................................................................ 94.75
W056 Repeat consultation ................................................................ 94.75CONSULTATIONS AND VISITS
DERMATOLOGY (02)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C025 Consultation............................................................................ 158.15
C026 Repeat consultation ................................................................ 47.75
C023 Specific assessment ............................................................... 46.15
C024 Specific re-assessment........................................................... 27.25
C020 Complex dermatology assessment - subject to same
conditions as A020 ............................................................. 60.00
Subsequent visits
C022 - first five weeks........................................................ per visit 40.05
C027 - sixth to thirteenth week (maximum 3 per patient per week)
............................................................................... per visit 40.05
C029 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C028 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05
NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
convalescent care beds in hospitals and nursing homes or homes for the aged, other than
patients in designated palliative care beds. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.CONSULTATIONS AND VISITS
ENDOCRINOLOGY & METABOLISM (15)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the emergency department when seeing patients in the
emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to
in-patients, use General Listings and Premiums when applicable - see General Preamble
GP65 to GP78.
C155 Consultation............................................................................ 172.95
C150 Comprehensive endocrinology consultation - subject to the
same conditions as A150 ................................................... 342.25
C255 Limited consultation ................................................................ 110.15
C156 Repeat consultation ................................................................ 110.15
C153 Medical specific assessment .................................................. 95.95
C154 Medical specific re-assessment.............................................. 72.00
C151 Complex medical specific re-assessment............................... 83.40
C760 Complex endocrine neoplastic disease assessment - subject
to the same conditions as A760 ......................................... 102.95
Subsequent visits
C152 - first five weeks........................................................ per visit 40.05
C157 - sixth to thirteenth week inclusive (maximum 3 per patient
per week................................................................ per visit 40.05
C159 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
intensive care area ............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see
General Preamble GP43)....................................... per visit 40.05
C158 Concurrent care ......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)........... per visit 40.05CONSULTATIONS AND VISITS
GASTROENTEROLOGY (41)
Subsequent visits
C412 - first five weeks....................................................... per visit 40.05
C417 - sixth to thirteenth week inclusive (maximum 3 per patient
per week) ............................................................... per visit 40.05
C419 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an intensive care area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
intensive care area ............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an intensive care area ........................................................ 71.80
C121 Additional visits due to intercurrent illness (see
General Preamble GP43) ...................................... per visit 40.05
C418 Concurrent care ......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
GENERAL SURGERY (03)
GENERAL LISTINGS
A035 Consultation............................................................................ 114.75
A935 Special surgical consultation (see General Preamble GP19). 194.65
A036 Repeat consultation ................................................................ 76.45
A033 Specific assessment ............................................................... 56.40
A034 Partial assessment ................................................................. 34.10
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C035 Consultation............................................................................ 114.75
C935 Special surgical consultation (see General Preamble GP19). 194.65
C036 Repeat consultation ................................................................ 76.45
C033 Specific assessment ............................................................... 56.40
C034 Specific re-assessment........................................................... 36.75
Subsequent visits
C032 - first five weeks........................................................ per visit 34.10
C037 - sixth to thirteenth week inclusive (maximum 3 per patient
per week) ............................................................... per visit 34.10
C039 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 34.10
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C038 Concurrent care .......................................................... per visit 34.10
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
GENERAL THORACIC SURGERY (64)
GENERAL LISTINGS
A645 Consultation............................................................................ 100.15
A935 Special surgical consultation (see General Preamble GP19). 194.65
A646 Repeat consultation ................................................................ 60.95
A643 Specific assessment ............................................................... 45.10
A644 Partial assessment ................................................................. 24.50
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
C645 Consultation............................................................................ 100.15
C935 Special surgical consultation (see General Preamble GP19). 194.65
C646 Repeat consultation ................................................................ 60.95
C643 Specific assessment ............................................................... 45.10
C644 Specific re-assessment........................................................... 26.40
Subsequent visits
C642 - first five weeks........................................................ per visit 31.00
C647 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C649 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C648 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit
40.05CONSULTATIONS AND VISITS
GERIATRICS (07)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C075 Consultation............................................................................ 255.85
C775 Comprehensive geriatric consultation - subject to the same
conditions as A775 ............................................................. 342.25
C770 Extended comprehensive geriatric consultation - subject to the
same conditions as A770 ................................................... 442.40
C375 Limited consultation ................................................................ 113.35
C076 Repeat consultation ................................................................ 113.35
C073 Medical specific assessment - subject to the same conditions
as A073 .............................................................................. 99.05
C074 Medical specific re-assessment- subject to the same
conditions as A074 ............................................................. 79.85
C071 Complex medical specific re-assessment- subject to the same
conditions as A071 ............................................................. 103.80
Subsequent visits
C072 - first five weeks........................................................ per visit 40.05
C077 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C079 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C078 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
HAEMATOLOGY (61)
For Services not listed, refer to Internal Medicine Section.
GENERAL LISTINGS
A615 Consultation............................................................................ 192.90
A655 Limited consultation ................................................................ 118.05
A616 Repeat consultation ................................................................ 118.05
A613 Medical specific assessment .................................................. 95.95
A614 Medical specific re-assessment.............................................. 72.00
A611 Complex medical specific re-assessment............................... 83.40
A618 Partial assessment ................................................................. 44.75
E078 - chronic disease assessment premium (see General
Preamble GP25) ................................................ add 50%
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C615 Consultation............................................................................ 192.90
C655 Limited consultation ................................................................ 118.05
C616 Repeat consultation ................................................................ 118.05
C613 Medical specific assessment .................................................. 95.95
C614 Medical specific re-assessment.............................................. 72.00
C611 Complex medical specific re-assessment............................... 83.40
Subsequent visits
C612 - first five weeks........................................................ per visit 40.05
C617 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C619 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80CONSULTATIONS AND VISITS
INFECTIOUS DISEASE (46)
Subsequent visits
C462 - first five weeks ....................................................... per visit 40.05
C467 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C469 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C468 Concurrent care ......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05
NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
convalescent care beds in hospitals and nursing homes or homes for the aged, other than
patients in designated palliative care beds. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble
GP65 to GP78.
W465 Consultation............................................................................ 205.90
W460 Comprehensive infectious disease consultation - subject to the
same conditions as A460 ................................................... 342.25
W275 Limited consultation ................................................................ 119.30
W466 Repeat consultation ................................................................ 124.00
Admission assessment
W292 - Type 1................................................................................. 69.35
W294 - Type 2................................................................................. 20.60
W297 - Type 3................................................................................. 30.70
W299 Periodic health visit................................................................. 65.05
W464 General re-assessment of patient in nursing home (as per the
Nursing Homes Act)* .......................................................... 20.60CONSULTATIONS AND VISITS
INTERNAL MEDICINE (13)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
C135 Consultation............................................................................ 192.85
C130 Comprehensive internal medicine consultation - subject to the
same conditions as A130 ................................................... 342.25
C435 Limited consultation ................................................................ 123.10
C136 Repeat consultation ................................................................ 123.10
C133 Medical specific assessment .................................................. 95.95
C134 Medical specific re-assessment.............................................. 72.00
C131 Complex medical specific re-assessment............................... 83.40
Subsequent visits
C132 - first five weeks........................................................ per visit 40.05
C137 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C139 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C138 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
MEDICAL ONCOLOGY (44)
GENERAL LISTINGS
A445 Consultation............................................................................ 183.40
A845 Limited consultation ................................................................ 115.95
A446 Repeat consultation ................................................................ 115.95
A443 Medical specific assessment .................................................. 95.95
A444 Medical specific re-assessment.............................................. 72.00
A441 Complex medical specific re-assessment............................... 83.40
A448 Partial assessment ................................................................. 44.75
E078 - chronic disease assessment premium (see General
Preamble GP25) ................................................ add 50%
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to
in-patients, use General Listings and Premiums when applicable - see General Preamble
GP65 to GP78.
C445 Consultation............................................................................ 183.40
C845 Limited consultation ................................................................ 115.95
C446 Repeat consultation ................................................................ 115.95
C443 Medical specific assessment .................................................. 95.95
C444 Medical specific re-assessment.............................................. 72.00
C441 Complex medical specific re-assessment............................... 83.40
Subsequent visits
C442 - first five weeks ....................................................... per visit 40.05
C447 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C449 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10CONSULTATIONS AND VISITS
NEPHROLOGY (16)
Subsequent visits
C162 - first five weeks ....................................................... per visit 40.05
C167 - sixth to thirteenth week inclusive (maximum 3 per patient
per week) ............................................................... per visit 40.05
C169 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment............... 71.80
C123 - second day following the hospital assessment ................... 71.80
C124 - day of discharge.................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions).......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................. 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area........................................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43) ................................................... per visit 40.05
C168 Concurrent care ......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50) ........... per visit 40.05
NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
convalescent care beds in hospitals and nursing homes or homes for the aged, other than
patients in designated palliative care beds. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble
GP65 to GP78.
W165 Consultation ............................................................................ 180.75
W160 Comprehensive nephrology consultation - subject to the same
conditions as A160 .............................................................. 342.25
W865 Limited consultation................................................................. 116.75
W166 Repeat consultation................................................................. 116.75
Admission assessment
W862 - Type 1 ................................................................................. 69.35
W864 - Type 2 ................................................................................. 20.60
W867 - Type 3 ................................................................................. 30.70
W869 Periodic health visit ................................................................. 65.05
W164 General re-assessment of patient in nursing home (as per the
Nursing Homes Act)*........................................................... 20.60CONSULTATIONS AND VISITS
NEUROLOGY (18)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C185 Consultation............................................................................ 225.55
C180 Special neurology consultation - subject to the same conditions
as A180 .............................................................................. 342.25
C682 Extended special neurology consultation - subject to the same
conditions as A682 ............................................................. 442.40
C384 Consultation and Management for ACVS - subject to the same
conditions as A384 ............................................................. 275.95
C385 Limited consultation ................................................................ 125.50
C186 Repeat consultation ................................................................ 125.50
C183 Medical specific assessment .................................................. 82.40
C184 Medical specific re-assessment.............................................. 64.95
C181 Complex medical specific re-assessment............................... 75.20
C113 Complex neurological assessment - subject to the same
conditions as A113 ............................................................. 120.00
Subsequent visits
C182 - first five weeks........................................................ per visit 40.05
C187 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C189 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ........................................................ 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C188 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
NEUROSURGERY (04)
GENERAL LISTINGS
A045 Consultation............................................................................ 145.60
A935 Special surgical consultation (see General Preamble GP19). 194.65
A046 Repeat consultation ................................................................ 64.85
A043 Specific assessment ............................................................... 64.90
A044 Partial assessment ................................................................. 33.40
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C045 Consultation............................................................................ 145.60
C935 Special surgical consultation (see General Preamble GP19). 194.65
C046 Repeat consultation ................................................................ 64.85
C043 Specific assessment ............................................................... 64.90
C044 Specific re-assessment........................................................... 33.40
Subsequent visits
C042 - first five weeks........................................................ per visit 31.00
C047 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C049 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C048 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
OBSTETRICS AND GYNAECOLOGY (20)
GENERAL LISTINGS
A205 Consultation* .......................................................................... 134.25
A935 Special surgical consultation (see General Preamble GP19). 194.65
A206 Repeat consultation* .............................................................. 71.45
A203 Specific assessment*.............................................................. 62.65
A204 Partial assessment ................................................................. 40.50
E432 - when pelvic exam including speculum is performed
outside of hospital or ICHSC, to A203, A204, A205 and
A206.......................................................................... add 5.00
Payment rules:
1.The collection of cervical cancer screening specimen(s) is included in the consultation,
repeat consultation, general or specific assessment (or re-assessment), or routine post-natal
visit when pelvic examination is normal part of the foregoing services. However, the add-on
codes E430 or E431 can be billed in addition to these services when collection of cervical
cancer screening specimen(s) is performed outside of a hospital or ICHSC.
2.E432 is limited to one service per patient per day.
3.E432 is only eligible for payment when the procedure is personally rendered by the
physician.
4.E432 is not eligible for payment with E430, E431, or E542.
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
C205 Consultation* .......................................................................... 134.25
C935 Special surgical consultation (see General Preamble GP19). 194.65
C206 Repeat consultation* .............................................................. 71.45
C203 Specific assessment*.............................................................. 62.65
C204 Specific re-assessment* ......................................................... 44.30
Subsequent visits
C202 - first five weeks........................................................ per visit 31.00
C207 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C209 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10CONSULTATIONS AND VISITS
OCCUPATIONAL MEDICINE (72)
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment ........... 71.80
C123 - second day following the hospital assessment ................ 71.80
C124 - day of discharge............................................................... 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions)....................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from
an Intensive Care Area .................................................... 71.80
C143 - second subsequent visit by the MRP following transfer
from an Intensive Care Area ............................................ 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C728 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05
NON-EMERGENCY LONG-TERM CARE IN-PATIENT SERVICES
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals,
Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or
convalescent care beds in hospitals and nursing homes or homes for the aged, other than
patients in designated palliative care beds. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
W725 Consultation............................................................................ 192.85
W720 Comprehensive occupational medicine consultation - subject
to the same conditions as A720 ......................................... 342.25
W925 Limited consultation ................................................................ 123.10
W726 Repeat consultation ................................................................ 123.10CONSULTATIONS AND VISITS
OPHTHALMOLOGY (23)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C235 Consultation............................................................................ 85.95
C935 Special surgical consultation (see General Preamble GP19). 194.65
C236 Repeat consultation ................................................................ 48.00
C231 Neuro-Ophthalmology Consultation – subject to the same
conditions as A231 ............................................................. 155.45
C930 Uveitis and ocular inflammatory diseases consultation, subject
to the same conditions as A930 ......................................... 157.00
C233 Specific assessment ............................................................... 60.50
C234 Specific re-assessment........................................................... 30.75
C250 Retinopathy of prematurity assessment - subject to the same
conditions as A250 ............................................................. 125.80
Subsequent visits
C232 - first five weeks........................................................ per visit 31.00
C237 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C239 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C238 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
ORTHOPAEDIC SURGERY (06)
GENERAL LISTINGS
A065 Consultation............................................................................ 89.80
A935 Special surgical consultation (see General Preamble GP19). 194.65
A066 Repeat consultation ................................................................ 55.35
A063 Specific assessment ............................................................... 45.55
A064 Partial assessment ................................................................. 25.95
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C065 Consultation............................................................................ 89.80
C935 Special surgical consultation (see General Preamble GP19). 194.65
C066 Repeat consultation ................................................................ 55.35
C063 Specific assessment ............................................................... 45.55
C064 Specific re-assessment........................................................... 27.30
Subsequent visits
C062 - first five weeks........................................................ per visit 31.00
C067 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C069 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C068 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
OTOLARYNGOLOGY (24)
GENERAL LISTINGS
A245 Consultation............................................................................ 92.70
A935 Special surgical consultation (see General Preamble GP19). 194.65
A246 Repeat consultation ................................................................ 53.65
A243 Specific assessment ............................................................... 44.75
A244 Partial assessment ................................................................. 30.45
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C245 Consultation............................................................................ 92.70
C935 Special surgical consultation (see General Preamble GP19). 194.65
C246 Repeat consultation ................................................................ 53.65
C243 Specific assessment ............................................................... 44.75
C244 Specific re-assessment........................................................... 31.00
Subsequent visits
C242 - first five weeks........................................................ per visit 31.00
C247 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C249 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment .............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C248 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
PAEDIATRICS (26)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C265 Consultation............................................................................ 190.35
C260 Special paediatric consultation - subject to the same conditions
as A260 .............................................................................. 342.25
C662 Extended special paediatric consultation - subject to the same
conditions as A662 ............................................................. 442.40
C667 Neurodevelopmental consultation - subject to same conditions
as A667 .............................................................................. 456.80
C665 Prenatal consultation - subject to the same conditions as A665 105.50
C565 Limited consultation ................................................................ 104.70
C266 Repeat consultation ................................................................ 104.70
C263 Medical specific assessment .................................................. 95.75
C264 Medical specific re-assessment.............................................. 70.75
C661 Complex medical specific re-assessment............................... 86.35
Subsequent visits
C262 - per visit ............................................................................... 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C268 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
PHYSICAL MEDICINE & REHABILITATION (31)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C315 Consultation............................................................................ 233.65
C425 Comprehensive physical medicine and rehabilitation
consultation – subject to the same conditions as A425...... 342.25
C515 Limited consultation ................................................................ 106.60
C316 Repeat consultation ................................................................ 106.60
C313 Medical specific assessment .................................................. 86.40
C314 Medical specific re-assessment.............................................. 75.90
C311 Complex medical specific re-assessment............................... 82.75
C510 Complex neuromuscular assessment - subject to the same
conditions as A510 ............................................................. 104.85
C511 Complex physiatry assessment - subject to the same
conditions as A511 ............................................................. 114.80
Subsequent visits
C312 - first five weeks........................................................ per visit 40.05
C317 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C319 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C318 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
PLASTIC SURGERY (08)
GENERAL LISTINGS
A085 Consultation............................................................................ 106.25
A935 Special surgical consultation (see General Preamble GP19). 194.65
A086 Repeat consultation ................................................................ 62.80
A083 Specific assessment ............................................................... 54.40
A084 Partial assessment ................................................................. 34.75
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C085 Consultation............................................................................ 106.25
C935 Special surgical consultation (see General Preamble GP19). 194.65
C086 Repeat consultation ................................................................ 62.80
C083 Specific assessment ............................................................... 54.40
C084 Specific re-assessment........................................................... 34.90
Subsequent visits
C082 - first five weeks........................................................ per visit 31.00
C087 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.00
C089 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C088 Concurrent care .......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
PSYCHIATRY (19)
EMERGENCY OR OUT-PATIENT DEPARTMENT (ODP)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to n-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C895 Consultation............................................................................ 297.00
C190 Special psychiatric consultation - subject to the same
conditions as A190 ............................................................. 342.25
C395 Limited consultation ................................................................ 120.30
C196 Repeat consultation ................................................................ 120.30
C795 Geriatric psychiatric consultation - subject to same conditions
as A795 .............................................................................. 342.25
C695 Neurodevelopmental consultation - subject to same conditions
as A695 .............................................................................. 456.80
C193 Specific assessment ............................................................... 98.70
C194 Specific re-assessment........................................................... 75.70
Subsequent visits
C192 - first five weeks........................................................ per visit 40.05
C197 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C199 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment .............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C198 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
RADIATION ONCOLOGY (34)
GENERAL LISTINGS
A345 Consultation............................................................................ 178.75
A745 Limited consultation ................................................................ 114.90
A346 Repeat consultation ................................................................ 114.90
A343 Medical specific assessment .................................................. 95.95
A340 Medical specific re-assessment.............................................. 72.00
A341 Complex medical specific re-assessment............................... 83.40
A348 Partial assessment ................................................................. 44.75
E078 - chronic disease assessment premium (see General
Preamble GP25) ................................................ add 50%
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C345 Consultation............................................................................ 178.75
C745 Limited consultation ................................................................ 114.90
C346 Repeat consultation ................................................................ 114.90
C343 Medical specific assessment .................................................. 95.95
C344 Medical specific re-assessment.............................................. 72.00
C341 Complex medical specific re-assessment............................... 83.40
Subsequent visits
C342 - first five weeks........................................................ per visit 40.05
C347 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C349 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80CONSULTATIONS AND VISITS
RESPIRATORY DISEASE (47)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C475 Consultation............................................................................ 185.80
C470 Comprehensive respiratory disease consultation - subject to
the same conditions as A470 ............................................. 342.25
C575 Limited consultation ................................................................ 115.30
C476 Repeat consultation ................................................................ 115.30
C473 Medical specific assessment .................................................. 99.15
C474 Medical specific re-assessment.............................................. 72.80
C471 Complex medical specific re-assessment............................... 86.40
C570 Complex respiratory assessment – subject to the same
conditions as A570 ............................................................. 105.25
Subsequent visits
C472 - first five weeks........................................................ per visit 40.05
C477 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C479 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment .............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area ....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C478 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
RHEUMATOLOGY (48)
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65 to
GP78.
C485 Consultation............................................................................ 201.95
C590 Comprehensive rheumatology consultation - subject to the
same conditions as A590 ................................................... 342.25
C595 Limited consultation ................................................................ 124.50
C486 Repeat consultation ................................................................ 124.50
C483 Medical specific assessment .................................................. 95.95
C484 Medical specific re-assessment.............................................. 72.00
C481 Complex medical specific re-assessment............................... 83.40
C480 Complex rheumatology assessment - subject to the same
conditions as A480 ............................................................. 112.00
Subsequent visits
C482 - first five weeks........................................................ per visit 40.05
C487 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 40.05
C489 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 40.05
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C488 Concurrent care .......................................................... per visit 40.05
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
UROLOGY (35)
GENERAL LISTINGS
A355 Consultation* .......................................................................... 93.15
A935 Special surgical consultation (see General Preamble GP19). 194.65
A356 Repeat consultation*............................................................... 64.90
A353 Specific assessment*.............................................................. 51.45
A354 Partial assessment ................................................................. 30.60
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in
the Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to in-
patients, use General Listings and Premiums when applicable - see General Preamble GP65
to GP78.
C355 Consultation* .......................................................................... 93.15
C935 Special surgical consultation (see General Preamble GP19). 194.65
C356 Repeat consultation*............................................................... 64.90
C353 Specific assessment*.............................................................. 51.45
C354 Specific re-assessment........................................................... 29.35
Subsequent visits
C352 - first five weeks........................................................ per visit 31.60
C357 - sixth to thirteenth week inclusive (maximum 3 per patient
per week)................................................................ per visit 31.60
C359 - after thirteenth week (maximum 6 per patient per month)
............................................................................... per visit 31.60
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43)..................................................... per visit 40.05
C358 Concurrent care .......................................................... per visit 31.60
C982 Palliative care (see General Preamble GP50)............ per visit 40.05CONSULTATIONS AND VISITS
VASCULAR SURGERY (17)
GENERAL LISTINGS
A175 Consultation............................................................................ 125.15
A935 Special surgical consultation (see General Preamble GP19). 194.65
A176 Repeat consultation ................................................................ 66.60
A173 Specific assessment ............................................................... 49.30
A174 Partial assessment ................................................................. 26.75
EMERGENCY OR OUT-PATIENT DEPARTMENT (OPD)
Physician in hospital but not on duty in the Emergency Department when seeing patients in the
Emergency or OPD - use General Listings.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES
See General Preamble GP40 to GP48. For emergency calls and other special visits to
in-patients, use General Listings and Premiums when applicable - see General Preamble
GP65 to GP78.
C175 Consultation............................................................................ 125.15
C935 Special surgical consultation (see General Preamble GP19). 194.65
C176 Repeat consultation ................................................................ 66.60
C173 Specific assessment ............................................................... 49.30
C174 Specific re-assessment........................................................... 28.80
Subsequent visits
C172 - first five weeks....................................................... per visit 31.00
C177 - sixth to thirteenth week inclusive (maximum 3 per patient
per week) ............................................................... per visit 31.00
C179 - after thirteenth week (maximum 6 per patient per month)
.............................................................................. per visit 31.00
Subsequent visits by the Most Responsible Physician (MRP)
See General Preamble GP44 to GP45 for terms and conditions.
C122 - day following the hospital admission assessment.............. 71.80
C123 - second day following the hospital assessment .................. 71.80
C124 - day of discharge ................................................................. 71.80
C126 - day of discharge, medically complex patient (see A13 for
terms and conditions) ......................................................... 95.10
Subsequent visits by the MRP following transfer from an Intensive Care Area
See General Preamble GP46 for terms and conditions.
C142 - first subsequent visit by the MRP following transfer from an
Intensive Care Area............................................................ 71.80
C143 - second subsequent visit by the MRP following transfer from
an Intensive Care Area....................................................... 71.80
C121 Additional visits due to intercurrent illness (see General
Preamble GP43) .................................................... per visit 40.05
C178 Concurrent care ......................................................... per visit 31.00
C982 Palliative care (see General Preamble GP50)........... per visit 40.05Fee master record
Master, record 501. Record Layout PDF, page 1.
C12620260401999999990000095100000000000000000000000000000000000000000000000
Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.
| Field | Raw / scale 10,000 |
|---|---|
| provider | 00000951000 / 95.1 |
| assistant | 00000000000 / 0 |
| specialist | 00000000000 / 0 |
| anaesthetist | 00000000000 / 0 |
| non anaesthetist | 00000000000 / 0 |
Explanation
AI-generated. Unreviewed.
A day of discharge visit for a medically complex patient, listed under subsequent visits by the MRP in the family practice section. It must meet all elements and payment rules of the MRP day of discharge visit (see GP45), and the terms in A13 apply.
Watch out for
Only eligible if the patient has been admitted to hospital for a minimum of 7 consecutive days.
Report an issue
Something off?
Report an issue with C126. Do not include patient names, health details or other personal information.