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Billing code

C194A — Psychiatry specific re-assessment – hospital in-patient

Psychiatry in-patient re-assessment

Bill when a psychiatrist re-assesses a non-emergency hospital in-patient with a full relevant history and exam of one or more systems.

Watch for: Limited to 2 per patient per physician in 12 months; routine follow-ups are subsequent visits (C192, C197, C199), not re-assessments.

Code

C194A

Description

Psychiatry 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

Specific re-assessment by a psychiatrist for a hospital in-patient: a full relevant history and exam of one or more systems.

What it covers

C194 is a specific re-assessment by a psychiatrist for a non-emergency hospital in-patient (A186).

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

Billing rules

• Limited to two per patient per physician per 12 months, except when rendered for a hospital admission. Excess claims pay as a lesser assessment (GP23).
• An admission assessment is a specific re-assessment when you assessed the patient and then admitted them for the same illness (GP23 commentary); if you saw the patient for the same illness within 90 days, the admission assessment is a re-assessment (GP40).
• Routine visits after the admission assessment are subsequent visits (C192, C197, C199), not re-assessments (GP43).
• 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: A194, C193, C192, C895, E082

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

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