Billing code
C435A — Internal medicine in-patient limited consultation
Internal medicine in-patient limited consultation
Bill for an internal medicine consultation on a hospital in-patient that is less demanding and takes much less time than a full one.
Watch for: Include the referrer's billing number; a referral requested after you saw the patient doesn't make the visit a consultation.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $123.10 | $0.00 | $0.00 | $0.00 |
- Code
- C435A
- Description
- Internal medicine in-patient limited consultation
- 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
Shorter, less demanding internal medicine consultation for a hospital in-patient, with all the requirements of a full consultation.
What it covers
C435 is the Internal Medicine (13) limited consultation for non-emergency hospital in-patients (A130). A limited consultation is less demanding and normally takes substantially less time than a full consultation; otherwise it has all the same requirements (GP19).
Hospital in-patient (C-prefix) services follow GP40–GP48. For emergency calls and other special visits to in-patients, use the General Listings and special visit premiums instead (A130).
Billing rules
- Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Internal Medicine (13) (GP9).
- Needs a written, signed request from a physician or nurse practitioner that names you or your specialty, the referrer and their billing number, and the patient and health number. Without it, OHIP pays a lesser assessment (GP16).
- Same patient, same consultant, same diagnosis: one consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first; a clearly unrelated diagnosis allows one every 12 months. Extra consultations pay as an assessment (GP17–GP18).
- A referral you ask for after seeing the patient does not make the visit a consultation; bill the visit you actually provided (GP16).
- Detention (K001) can be added only after 60 minutes of consultation time (GP30–GP31).
- Video only (not phone), and for a hospital in-patient or LTC resident only if you are not the MRP, the facility has no physician with the needed expertise (documented by the referrer), and the referrer saw the patient in person within the past 30 days (AJ2, A69).
Common rejections
- ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
- AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).
Related codes: C135, C136, C130, A435, W435
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A130. Consultation rules GP16–GP19.
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