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Billing code

C204A — Obstetrics and gynaecology specific re-assessment – hospital in-patient

Obstetrics-gynaecology in-patient re-assessment

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

Watch for: Two per patient per physician in 12 months, except admission assessments; extras pay as a lesser assessment.

Code

C204A

Description

Obstetrics and gynaecology 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

Obstetrics and gynaecology specific re-assessment of a hospital in-patient: full relevant history and exam of one or more systems.

What it covers

C204 is a specific re-assessment by an obstetrician-gynaecologist for a non-emergency hospital in-patient (A150). It needs a full, relevant history and physical examination of one or more systems (GP23).

Marked *: includes, where indicated, biopsy of the cervix, collection of cervical cancer screening specimens and examination of trichomonas suspension (A151, note).

Billing rules

• Two per patient per physician per 12 months, except when rendered as a hospital admission assessment. Extras pay as a lesser assessment (GP23).
• It is the admission assessment when the physician assessed the patient for the same illness within the previous 90 days (GP40), or when a surgical specialist assessed the patient before admission for a Z-code (IOP) procedure (GP23 commentary).
• A surgeon can't bill the hospital admission assessment unless it is the major pre-operative visit (SP2, §1; GP40 commentary).
• Detention (K001) is payable only after 40 minutes (GP30).
• Can be done by video only (not telephone) with K300A, for a patient with an existing relationship (Appendix J AJ2; A70). For in-patients the virtual physician must not be the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within the past 30 days (A69, rule 8).

Often billed with

• E082 (+30%) applies when the admitting MRP's admission assessment is this service; not for admissions for obstetrical delivery or day surgery (GP42).

Common rejections

• A4D: 'Invalid specialty for this service code': these codes are for Obstetrics and Gynaecology (20). Specialists must bill from their own specialty's listings (GP9).
• AT2: 'Must include video modality': this code is video-only for virtual care, so it can't be billed with K301A telephone (Appendix J AJ2).

Related codes: C203, C205, C202, C122, C124, E082

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Obstetrics and Gynaecology (20), page A150.

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