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Billing code

C185A — Neurology consultation – hospital in-patient

Neurology in-patient consultation

Bill when a neurologist consults on a hospital in-patient at the written request of a physician or nurse practitioner.

Watch for: Include the referrer's billing number from the signed written request, or it is refused or paid as a lesser assessment.

Code

C185A

Description

Neurology consultation – 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

A neurologist's consultation for a hospital in-patient, at the written request of another physician or a nurse practitioner.

What it covers

A consultation is an assessment done after a written request from a referring physician, nurse practitioner or (for an insured dental procedure in hospital) dental surgeon, because of the complexity, seriousness or obscurity of the case, or because another opinion is requested (GP16).

The consultant does a general, specific or medical specific assessment, reviews all relevant data, and sends a written report with findings, opinions and recommendations (GP16). C185 is the Neurology (18) in-patient listing (A144).

Billing rules

• Same patient, same diagnosis: 1 consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient, 12 to 24 months after the first (GP17).
• A clearly unrelated diagnosis allows 1 consultation every 12 months (GP17).
• Keep the signed written request (it can be in the common hospital record). It must name you or your specialty, the referrer with billing number, and the patient with health number, or it is paid as a lesser assessment (GP16).
• If you have not assessed the patient for the same illness within 90 days, your admission assessment counts as a consultation or assessment. When an in-patient is transferred between physicians, only one consultation or assessment is payable per admission (GP40).
• Patients under 16 get an age premium of 10% to 30% on specialist consultations (GP64).
• 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).

Often billed with

• E082 (+30%) when the consultation is your admission assessment as the MRP, once per admission (GP42).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation needs the referring physician's or nurse practitioner's billing number from the written request (GP16).
• 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: C180, C682, C385, C186, A185, C183, E082

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A144. Rules GP16–GP18, GP40.

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