What are the billing rules for C414A?

Limited to 2 per patient per physician in any 12 consecutive months, except re-assessments done for hospital admissions; extra ones are paid at a lesser assessment fee (GP23). An admission assessment counts as a medical specific re-assessment when you assessed the patient for the same illness within the previous 90 days (GP40, GP23). When an in-patient is transferred between physicians, only one consultation or assessment is payable per admission (GP40).

What is C414A often billed with?

E082 MRP admission premium, when C414 is the admission assessment and you are the most responsible physician (GP42).

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Billing code

C414A — Medical Specific Re-assessment

Q: What is OHIP billing code C414A?

Gastroenterologist's medical specific re-assessment of a hospital in-patient: a full relevant history and exam of one or more systems.

Gastroenterology in-patient re-assessment

Bill when a gastroenterologist 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; routine follow-ups are subsequent visits (C412, C417, C419).

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$72.00	$0.00	$0.00	$0.00

Code: C414A
Description: Medical Specific Re-assessment
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

Gastroenterologist's medical specific re-assessment of a hospital in-patient: a full relevant history and exam of one or more systems.

What it covers

C414 is the medical specific re-assessment for non-emergency hospital in-patients in the Gastroenterology (41) listings (A105). The office version is A414 (A104).

A medical specific re-assessment is a specialist service that requires a full, relevant history and physical examination of one or more systems (GP23).

Billing rules

Limited to 2 per patient per physician in any 12 consecutive months, except re-assessments done for hospital admissions; extra ones are paid at a lesser assessment fee (GP23).
An admission assessment counts as a medical specific re-assessment when you assessed the patient for the same illness within the previous 90 days (GP40, GP23).
When an in-patient is transferred between physicians, only one consultation or assessment is payable per admission (GP40).
Routine visits after the admission assessment are subsequent visits (C412, C417, C419), not re-assessments (GP43, A106).
For emergency calls and other special visits to in-patients, use the General Listings and special visit premiums instead (A105).
For a complex, obscure or serious condition with a written report to the primary care physician, the code is C411 complex medical specific re-assessment (GP24, A105).
The gastroenterology chronic disease premium E098 does not apply to in-patients (A104).

Often billed with

E082 MRP admission premium, when C414 is the admission assessment and you are the most responsible physician (GP42).

Related codes: A414, C413, C411, C415, C416, C412, C418

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Gastroenterology (41), page A105.

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