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Billing code

C113A — Complex Neurological Assessment - Subject To The Same Conditions As A113

Complex neurology in-patient assessment

Bill C113 for 20+ minutes of a neurologist's ongoing in-patient care for a listed complex chronic neurological condition.

Watch for: Not payable for your first evaluation; record start and stop times, or it pays less; limit 6 per 12 months.

Code

C113A

Description

Complex Neurological Assessment - Subject To The Same Conditions As A113

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

Complex neurological assessment of a hospital in-patient: 20+ minutes for ongoing care of a listed complex chronic neurological condition.

What it covers

C113 is the hospital in-patient version of A113 and is subject to the same conditions (A144). It is for ongoing management of a listed complex chronic neurological condition that needs continuing neurologist care, with at least 20 minutes in direct contact with the patient (A141).

It is for ongoing management of: generalized peripheral neuropathies, myopathies, neuromuscular junction and motor neurone diseases; malignant brain neoplasms, functional neurological disorder, chronic migraine or trigeminal autonomic cephalalgias, Huntington's chorea, trigeminal neuralgia, intracranial haemorrhage and stroke; and neuro-oncology conditions (primary CNS tumour, CNS metastasis, neurological complications of cancer therapy, paraneoplastic syndromes) (A141–A142).

Billing rules

• Must include the elements of a medical specific re-assessment, or it is paid as a lesser assessment (A142).
• Not payable for your initial evaluation of the patient; bill a consultation or assessment for that first visit (A142).
• Limited to 6 per patient per physician per 12 months; extra ones are paid as a lesser assessment (A142).
• The patient must have an established diagnosis of a chronic complex neurological disease documented in the chart (A142).
• Needs at least 20 minutes in direct contact with the patient, not counting other separately billable services. Record start and stop times, or it is paid at a lesser fee (A141, A142).
• E078 is not payable with A113 (A142).
• Not meant for uncomplicated conditions such as carpal tunnel syndrome, Bell's palsy or asymptomatic diabetic neuropathy (A142).
• Video only (not phone), with K300A. For in-patients, virtual care is payable only if you are not the MRP, no physician with your expertise is on staff and present in the community (documented by the referrer), and the referrer assessed the patient in person within the 30 days before (Appendix J AJ2, A69).

Common rejections

• AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual list, so it can't be billed by phone (K301A) (Appendix J AJ2).

Related codes: A113, C184, C181, C183, C182, W113

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A144. Conditions on A141–A142.

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