Billing code
C484A — Rheumatology medical specific re-assessment – hospital in-patient
Rheumatology in-patient re-assessment
Bill when a rheumatologist 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 | $72.00 | $0.00 | $0.00 | $0.00 |
- Code
- C484A
- Description
- Rheumatology medical 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
Medical specific re-assessment by a rheumatologist for a hospital in-patient.
What it covers
A medical specific re-assessment needs a full, relevant history and exam of one or more systems (GP23).
An admission assessment is treated as a re-assessment when the same physician assessed the patient for the same illness before admitting them (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 (A205, GP12).
- Limited to two per patient per physician per 12 months, except re-assessments for hospital admissions (GP23).
- 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: C483, C481, C480, A484, C482
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), Non-emergency hospital in-patient services, page A205.
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