Billing code
C004A — General Re-assessment
Hospital general re-assessment
Bill C004 for a family physician's general re-assessment of an in-patient, often the admission of a patient recently assessed for that illness.
Watch for: Two per patient per physician per 12 months, except admissions; not payable after your pre-operative assessment within 30 days.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $38.35 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- C004A
- Description
- General Re-assessment
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Jun 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
General re-assessment of a hospital in-patient by a family physician, often the admission assessment for a patient seen recently for the same illness.
What it covers
A general re-assessment includes everything in a general assessment, except that the history need not repeat details already obtained (GP22).
If you assessed the patient for the same presenting illness within 90 days before admitting them, the admission assessment is a general re-assessment (GP40).
Billing rules
- Limit two general re-assessments per patient per physician per 12 months, except those rendered for hospital admissions; extra ones are paid at a lesser fee (GP22).
- An ED physician who did a lesser assessment in the ED and then does the admission assessment is paid C004 for it (GP42).
- Not payable as the admission assessment for an elective surgery patient if you did a pre-operative assessment within 30 days (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 40 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: C003, C005, C933, A004, E082, C122
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A12; rules GP22, GP40–GP42.
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