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Billing code

C003A — General Assessment

Hospital general assessment

Bill C003 for a family physician's full general assessment of a hospital in-patient, usually the admission assessment.

Watch for: One per patient per physician per 12 months; if you assessed the same illness in the past 90 days, bill C004.

Code

C003A

Description

General Assessment

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Full general assessment of a hospital in-patient by a family physician, usually the admission assessment. Full history and exam of all systems.

What it covers

A general assessment needs a full history (presenting complaint, family, past and social history, and a functional inquiry into all body parts and systems) and an exam of all body parts and systems, except breast, genital or rectal exam when not indicated or refused (GP21).

In hospital it is usually the admission assessment. If you have not assessed the patient for the same illness in the past 90 days, the admission assessment is a consultation or general assessment; if you have, it is a general re-assessment (C004) (GP40).

Billing rules

• Limit one general assessment per patient per physician per 12 months; two if the second is for a clearly different diagnosis, or at least 90 days have passed and the second is a hospital admission assessment. Extra ones are paid at a lesser fee (GP21).
• Only one consultation or assessment is payable per admission when the patient is transferred between physicians in the same hospital (GP40).
• Not payable as the admission assessment for an elective surgery patient if you did a pre-operative assessment within 30 days of admission (GP41).
• If you did a consultation, general assessment or general re-assessment in the ED or OPD and then admit the patient, that service is the admission assessment (GP41).
• Patients 65 and over: the fee is increased by 15% automatically (GP64).
• Add E082 when you are the MRP and did the admission assessment (GP42).
• Detention (K001) can start only after 60 minutes (GP30).
• FHO: counts toward the hospital services special payment (Agreement Schedule 3, p.90; §8.5, p.66). In-patient services to enrolled patients are paid full fee-for-service (Agreement p.64 §7.2).

Often billed with

• E082 admission assessment by the MRP premium (GP42).

Related codes: C004, C005, C933, A003, E082, C122

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A12; rules GP21, GP40–GP42.

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