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Billing code

C153A — Endocrinology medical specific assessment – hospital in-patient

Endocrinology in-patient specialist assessment

Bill C153 for an endocrinologist's full history of the complaint and detailed exam of the affected systems for a hospital in-patient.

Watch for: One per patient per 12 months, unless the diagnosis is clearly unrelated; E078 isn't payable for in-patients.

Code

C153A

Description

Endocrinology medical specific assessment – hospital in-patient

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

Medical specific assessment of a hospital in-patient by an endocrinologist: full history of the complaint and detailed exam of the affected systems.

What it covers

A medical specific assessment is a specialist service that needs a full history of the presenting complaint and a detailed exam of the affected parts, regions or systems needed to make a diagnosis, exclude disease or assess function (GP23).

C153 is the in-patient code; A153 is the office code (A98, A102).

Billing rules

• Limited to one per patient per 12 months, or two if the second is for a clearly different, unrelated diagnosis, or is a hospital admission assessment at least 90 days after the last. Medical specific assessments and complex medical specific re-assessments together are limited to 4 per 12 months; excess claims pay a lesser fee (GP23, GP24).
• When you admit a patient you haven't assessed for the same illness in the past 90 days, the admission assessment is a consultation or medical specific assessment; if you did assess them within 90 days, it is a re-assessment (GP40).
• Only one consultation or assessment is payable per admission when the patient is transferred between physicians in the same hospital (GP40).
• The chronic disease premium E078 is not payable for hospital in-patients (GP25).
• Detention (K001) is only payable after 60 minutes (GP30).
• By video only for an in-patient or long-term care resident, and only if you aren't the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within the past 30 days (Appendix J AJ2, A69).

Often billed with

• E082 MRP admission premium (+30%) when this is your admission assessment as MRP (GP42).

Related codes: A153, C154, C151, C155, C152, E082

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A102; rules GP23–GP24, GP40.

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