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Billing code

C073A — Geriatric in-patient medical specific assessment

Geriatric in-patient specialist assessment

Bill C073 for a geriatrician's full specialist assessment of a hospital in-patient aged 65+, or of any in-patient assessed for dementia.

Watch for: Only payable for patients 65 or older, or for a dementia assessment; one per patient per physician per 12 months.

Code

C073A

Description

Geriatric in-patient medical specific 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 geriatric specialist assessment of a hospital in-patient aged 65+, or of any in-patient being assessed for dementia.

What it covers

C073 is the in-patient version of A073 and has the same conditions (A121). A medical specific assessment needs a full history of the presenting complaint and a detailed examination of the affected parts, regions or systems needed to make a diagnosis, exclude disease or assess function. It is done by a specialist, somewhere other than the patient's home (GP23).

Hospital in-patient (C-prefix) services follow GP40–GP48. For emergency calls and other special visits to in-patients, use the General Listings and special visit premiums instead (A121).

Billing rules

• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Geriatrics (07) (GP9).
• Only payable for a patient at least 65 years old, or at any age when the visit is to assess dementia (A120).
• One per patient per physician per 12 months, or two if the patient returns with a clearly different, unrelated diagnosis or (at least 90 days after the last) the second is a hospital admission assessment. Extra ones pay a lesser fee (GP23).
• Medical specific assessments and complex medical specific re-assessments together are limited to 4 per patient per physician per 12 months; extras pay a lesser fee (GP23–GP24).
• As an admission assessment, it applies when you haven't assessed the patient for the same illness in the 90 days before admission (GP40).
• The chronic disease assessment premium (E078) is not payable for hospital in-patients (GP25).
• Video only (not phone), and for a hospital in-patient or LTC resident only if you are not the MRP, the facility has no physician with the needed expertise (documented by the referrer), and the referrer saw the patient in person within the past 30 days (AJ2, A69).

Common rejections

• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: C074, C071, C075, A073, C072

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A121. Same conditions as A073 (A120).

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