Billing code
C311A — Physiatry complex medical specific re-assessment – hospital in-patient
Physiatry complex in-patient re-assessment
Bill when a physiatrist re-assesses a hospital in-patient because the condition is complex, obscure or serious.
Watch for: Send a written report to the patient's primary care physician, or it pays a lesser fee.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $82.75 | $0.00 | $0.00 | $0.00 |
- Code
- C311A
- Description
- Physiatry complex medical 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
In-patient physiatrist re-assessment for a complex, obscure or serious condition, with a written report to the primary care physician.
What it covers
A complex medical specific re-assessment is a re-assessment because of the complexity, obscurity or seriousness of the patient's condition. It includes all the requirements of a medical specific re-assessment (GP24).
C311 is the Physical Medicine & Rehabilitation (31) code for a non-emergency hospital in-patient (A178).
Billing rules
- Report findings, opinions or recommendations in writing to the patient's primary care physician, or it is paid at a lesser fee (GP24).
- Limited to 4 per patient per physician per 12 months; extras are paid at a lesser fee (GP24).
- Medical specific assessments and complex medical specific re-assessments together are limited to 4 per patient per physician per 12 months (GP23, GP24).
- Non-emergency hospital in-patient service. For emergency calls and other special visits to in-patients, use the General Listings (A prefix) with premiums (A178, GP65–GP78).
- Video only (never telephone) as virtual care (Appendix J, AJ2). For in-patients or long-term care residents, the virtual physician must not be the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer must have assessed the patient in person within 30 days (A69).
Common rejections
- AT2: This code may be billed by video only (Appendix J, AJ2). A virtual claim must carry K300A, not K301A (telephone).
Related codes: A311, C313, C314, C511, C312
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Physical Medicine & Rehabilitation (31), page A178.
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