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Billing code

C205A — Obstetrics and gynaecology consultation – hospital in-patient

Obstetrics-gynaecology in-patient consultation

Bill when an obstetrician-gynaecologist consults on a non-emergency 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; a request obtained after the service doesn't support a consultation.

Code

C205A

Description

Obstetrics and gynaecology 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

Obstetrics and gynaecology consultation for a hospital in-patient, at the written request of another physician or nurse practitioner.

What it covers

C205 is a consultation by an obstetrician-gynaecologist (specialty 20) for a non-emergency hospital in-patient (A150). Emergency calls and other special visits to in-patients are billed from the General Listings (A prefix) with special visit premiums (A150; GP65–GP78).

Marked *: includes, where indicated, biopsy of the cervix, collection of cervical cancer screening specimens and examination of trichomonas suspension (A151, note). The consultant performs a general, specific or medical specific assessment, reviews all relevant data and sends a written report to the referrer (and to the primary care provider when an NP referred) (GP16).

Billing rules

• Needs a written, signed request from a physician, nurse practitioner or (for an insured hospital dental procedure) dental surgeon, kept in the chart or common hospital/LTC record, naming the consultant or specialty, the referrer and billing number, and the patient and health number. Otherwise it pays as a lesser assessment (GP16).
• Same patient, same diagnosis: one consultation per two consecutive 12-month periods (a second is allowed only for a hospital in-patient or ED patient 12–24 months after the first). A clearly unrelated diagnosis: one every 12 months. Extra consultations pay as an assessment (GP17–GP18).
• A request obtained after the service has been provided doesn't support a consultation; bill the visit actually rendered (GP16 commentary).
• A special surgical consultation, with at least 50 minutes of direct patient contact, is C935 (A150; GP19).
• An admission assessment by a physician who hasn't assessed the patient for the same illness in the past 90 days is a consultation or specific assessment; within 90 days it is a specific re-assessment. Only one such service is payable per admission when care is transferred within the hospital (GP40). A surgeon can't bill the hospital admission assessment unless it is the major pre-operative visit (SP2, §1; GP40 commentary).
• Specialist consultations and repeat consultations get an age premium for patients under 16: 30% under 30 days, 25% to 1 year, 20% to 2 years, 15% to 5 years, 10% to 16 years (GP64).
• 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

• ARF: 'Missing physician referring number': a consultation needs the referring provider's number from the written request (GP16).
• 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: C206, C935, C203, C204, A205, W305, E082

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

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