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Billing code

C193A — Psychiatry specific assessment – hospital in-patient

Psychiatry in-patient specific assessment

Bill when a psychiatrist takes a full history of the complaint and examines the affected systems of a non-emergency hospital in-patient.

Watch for: One per patient per physician per 12 months, two only for a clearly unrelated diagnosis; extras pay as a lesser assessment.

Code

C193A

Description

Psychiatry 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

Specific assessment by a psychiatrist for a hospital in-patient: full history of the complaint and detailed exam of the affected systems.

What it covers

C193 is a specific assessment by a psychiatrist for a non-emergency hospital in-patient (A186).

A specific assessment is a specialist service, not in the patient's home, that needs a full history of the presenting complaint and a detailed examination of the affected parts, regions or systems needed to make a diagnosis, exclude disease or assess function (GP23).

Billing rules

• One per patient per physician per 12 months; two if the second has a clearly different, unrelated diagnosis. Excess claims pay as a lesser assessment (GP23).
• If you admit a patient you haven't seen for the same illness in the past 90 days, this can be the admission assessment; only one consultation or assessment is paid per admission when the patient is transferred between physicians in the same hospital (GP40).
• 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).
• Out-of-hospital psychotherapy, psychiatric care or hypnotherapy the same day as an assessment by the same physician is not paid unless the diagnoses are clearly different (GP55).
• For emergency calls and other special visits to in-patients, bill the General Listings (A-prefix) with the special visit premiums instead (A186, GP65–GP78).
• 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

• E082 MRP admission premium when this is the admission assessment (GP42).

Common rejections

• 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: A193, C194, C895, C192, E082

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A186. Rules GP23, GP40.

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