What are the billing rules for C355A?

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). Needs a written, signed request naming you or your specialty, the referrer and billing number, and the patient and health number; in hospital it may be on the common medical record (GP16). Limited to one per patient per physician for the same diagnosis in two consecutive 12-month periods; a second is allowed for an in-patient or ED consultation 12–24 months after the first (GP17).

Why is C355A rejected?

ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16). 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).

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Billing code

C355A — Urology consultation – hospital in-patient

Q: What is OHIP billing code C355A?

Urology consultation for a hospital in-patient, following a written request.

Urology in-patient consultation

Bill when a urologist consults on a non-emergency hospital in-patient following a signed written request.

Watch for: Include the referrer's billing number; a consultation with 50 minutes or more of direct contact is C935 instead.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$93.15	$0.00	$0.00	$0.00

Code: C355A
Description: Urology 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

Urology consultation for a hospital in-patient, following a written request.

What it covers

C355 is the urology consultation for a non-emergency acute hospital in-patient (A206). A consultation is an assessment requested in writing because of the complexity, seriousness or obscurity of the case, or for another opinion (GP16).

A consultation with at least 50 minutes of direct contact is the special surgical consultation, C935 (A206, GP19).

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).
Needs a written, signed request naming you or your specialty, the referrer and billing number, and the patient and health number; in hospital it may be on the common medical record (GP16).
Limited to one per patient per physician for the same diagnosis in two consecutive 12-month periods; a second is allowed for an in-patient or ED consultation 12–24 months after the first (GP17).
Starred (*) urology consults and assessments may include a genito-urinary exam and, when needed, urethral calibration, catheterization and prostatic fluid examination, but not endoscopy (A207).
Age premium of 10–30% for patients under 16 (GP64).
Detention (K001) may start after 60 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

ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16).
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: A355, C935, C356, C353, C354

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Urology (35), Non-emergency hospital in-patient services, page A206.

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