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Billing code

C154A — Endocrinology medical specific re-assessment – hospital in-patient

Endocrinology in-patient re-assessment

Bill C154 for an endocrinologist's in-patient re-assessment with a relevant history and exam of one or more systems.

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

Code

C154A

Description

Endocrinology medical specific re-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 re-assessment of a hospital in-patient by an endocrinologist: relevant history and exam of one or more systems.

What it covers

A medical specific re-assessment is a specialist service that needs a full, relevant history and physical exam of one or more systems (GP23).

An admission assessment is treated as a re-assessment when the same physician assessed the patient for the same illness before admitting them (GP23, GP40). C154 is the in-patient code; A154 is the office code (A98, A102).

Billing rules

• Limited to two per patient per 12 months, except re-assessments done for hospital admissions; excess claims pay a lesser fee (GP23).
• If you assessed the patient for the same illness within 90 days before admitting them, the admission assessment is a re-assessment (GP40).
• The chronic disease premium E078 is not payable for hospital in-patients (GP25).
• Detention (K001) is only payable after 40 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: A154, C153, C151, C152, C760

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

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