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Billing code

C190A — Special psychiatric consultation – hospital in-patient

Special psychiatric in-patient consultation

Bill for a full psychiatric consultation on a hospital in-patient with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the patient's chart, or the service isn't eligible for payment.

Code

C190A

Description

Special psychiatric 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

Special psychiatric consultation for a hospital in-patient: a full consultation with at least 75 minutes of direct patient contact.

What it covers

C190 is the in-patient version of A190, on the same conditions (A186). The psychiatrist provides all the elements of a consultation (A195) and spends at least 75 minutes in direct contact with the patient, not counting time spent on any other separately billable service (A183).

Time also excludes non-patient-facing work such as reviewing charts, imaging or documentation (A183 commentary).

Billing rules

• Record start and stop times in the patient's permanent record, or the service is not eligible for payment (A183).
• Needs a written, signed request naming you or the specialty, the referrer and their billing number, and the patient and health number, kept in your chart (a common hospital record is fine). Without it OHIP pays a lesser assessment (GP16).
• Same patient, same diagnosis: one consultation per two consecutive 12-month periods; a second is allowed only for an in-patient or ED patient 12 to 24 months after the first. Excess claims pay as an assessment (GP17, GP18). Time-based consultations count toward this limit (GP18).
• Extra time the same day can be billed as K630 consultation extension: the first unit starts after 90 minutes with the patient, so 106 minutes in total are needed for one K630 unit; maximum 6 units per day (A185).
• If this is your admission assessment and you are the MRP, E082 (+30%) may be added once per admission; not for transfers within the same hospital (GP42).
• Virtual care: video only, not phone (AJ2). For an in-patient you must not be the MRP, the hospital must lack a local physician with the expertise (documented by the referrer), and for a consultation the referrer must have seen the patient in person within 30 days (A69).

Often billed with

• K630 psychiatric consultation extension, per unit (A185).
• E082 MRP admission premium when this is the admission assessment (GP42).

Common rejections

• ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
• AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).

Related codes: A190, W190, C895, C795, C695, K630, E082

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A186. Conditions at A183; K630 at A185.

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