< Billing codes

Billing code

C074A — Geriatric in-patient medical specific re-assessment

Geriatric in-patient re-assessment

Bill C074 for a geriatrician's follow-up re-assessment of an in-patient aged 65+, or any in-patient assessed for dementia.

Watch for: Limited to 2 per patient per physician per 12 months, except admission re-assessments; extras pay a lesser fee.

Code

C074A

Description

Geriatric in-patient medical specific re-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

Follow-up specialist re-assessment of a hospital in-patient by a geriatrician. Patients 65+ or any patient assessed for dementia.

What it covers

C074 is the in-patient version of A074 and has the same conditions (A121). A medical specific re-assessment needs a full, relevant history and a physical examination of one or more systems (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).
• Limited to 2 per patient per physician per 12 months, except re-assessments done for a hospital admission. Extras pay a lesser fee (GP23).
• As an admission assessment, it applies when you assessed the patient for the same illness within 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: C073, C071, A074, C072, C075

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A121. Same conditions as A074 (A120).

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing