Billing code
C354A — Urology specific re-assessment – hospital in-patient
Urology in-patient re-assessment
Bill when a urologist re-assesses a 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, except admission re-assessments; virtual care must be video, not phone.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $29.35 | $0.00 | $0.00 | $0.00 |
- Code
- C354A
- Description
- Urology 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 of a hospital in-patient by a urologist: full relevant history and exam of one or more systems.
What it covers
A specific re-assessment is rendered by a specialist and needs a full, relevant history and physical exam of one or more systems (GP23).
An admission assessment is treated as a specific re-assessment when a surgeon who assessed the patient before admission for the same illness admits them for a Z-coded procedure (GP23).
Billing rules
- C-prefix codes are for non-emergency services to acute hospital in-patients; emergency calls and special visits to in-patients use the A-prefix General Listings with premiums (A206, GP12).
- Limited to two per patient per physician per 12 months, except re-assessments for hospital admissions (GP23).
- A surgeon may bill the hospital admission assessment only if it is the major pre-operative visit (SP2).
- Detention (K001) may start after 40 minutes (GP30).
- By video only, and for in-patients only when you aren't the MRP, no local physician with the expertise is available, and the referrer assessed the patient in person within the prior 30 days (Appendix J, A66).
Common rejections
- AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual care list, so it can't be billed by telephone (K301A) (Appendix J).
Related codes: C353, C355, C352, A354
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Urology (35), Non-emergency hospital in-patient services, page A206.
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