Billing code
C181A — Complex Medical Specific Re-assessment
Complex neurology in-patient re-assessment
Bill C181 when a neurologist re-assesses an in-patient because the condition is complex, obscure or serious.
Watch for: Report in writing to the primary care physician, or it pays as a lesser assessment; limit 4 per patient per 12 months.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $75.20 | $0.00 | $0.00 | $0.00 |
- Code
- C181A
- Description
- Complex Medical Specific Re-assessment
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Jun 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
A neurologist's re-assessment of a hospital in-patient with a complex, obscure or serious condition, reported to the primary care physician.
What it covers
A complex medical specific re-assessment is a re-assessment because of the complexity, obscurity or seriousness of the patient's condition, with all the requirements of a medical specific re-assessment (GP24).
C181 is the Neurology (18) hospital in-patient listing (A144).
Billing rules
- Report your findings, opinions or recommendations in writing to the patient's primary care physician, or it is paid as a lesser assessment (GP24).
- Limited to 4 per patient per physician per 12 months, and 4 combined with medical specific assessments (GP24).
- E078 is not payable for in-patients (GP25).
- 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: C184, C183, C113, A181, C182
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A144. Rules GP24.
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