< Billing codes

Billing code

C483A — Rheumatology medical specific assessment – hospital in-patient

Rheumatology in-patient specific assessment

Bill when a rheumatologist takes a full history of the complaint and examines the affected systems of a hospital in-patient.

Watch for: One per patient per physician per 12 months, two only for a different diagnosis or later admission; virtual care must be video.

Code

C483A

Description

Rheumatology medical specific 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

Medical specific assessment by a rheumatologist for a hospital in-patient.

What it covers

A medical specific assessment needs a full history of the presenting complaint and a detailed exam of the affected part(s), region(s) or system(s) needed to make a diagnosis, exclude disease or assess function (GP23).

C483 is the in-patient version of A483 (A205). An admission assessment by a physician who hasn't seen the patient for the same illness within 90 days may be a consultation or specific assessment (GP40).

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 (A205, GP12).
• Limited to one per patient per physician per 12 months; two if a clearly different diagnosis is made, or if 90+ days later the second is a hospital admission assessment (GP23).
• Medical specific assessments and complex medical specific re-assessments combined are limited to 4 per patient per physician per 12 months (GP23–GP24).
• The chronic disease premium E078 is not payable for in-patients (GP25).
• 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).

Often billed with

• E082 MRP admission premium when this is the MRP's admission assessment (GP42).

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: C484, C481, C480, A483, C485

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), Non-emergency hospital in-patient services, page A205.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing