What are the billing rules for C590A?

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). 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 C590A 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).

< Billing codes

Billing code

C590A — Comprehensive rheumatology consultation – hospital in-patient

Q: What is OHIP billing code C590A?

Comprehensive rheumatology consultation for an in-patient: at least 75 minutes of direct contact, same conditions as A590.

Comprehensive rheumatology in-patient consultation

Bill for a rheumatology consultation on a hospital in-patient with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the chart, or it pays a lesser fee.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$342.25	$0.00	$0.00	$0.00

Code: C590A
Description: Comprehensive rheumatology 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

Comprehensive rheumatology consultation for an in-patient: at least 75 minutes of direct contact, same conditions as A590.

What it covers

C590 is the in-patient version of the comprehensive rheumatology consultation, subject to the same conditions as A590 (A205).

A590 requires all elements of a consultation and at least 75 minutes of direct contact, excluding separately billable services and non-patient-facing work (A200).

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).
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).
Age premium of 10–30% for patients under 16 (GP64).
Record start and stop times in the chart, or it is paid at a lesser fee (A200, A205).
Detention (K001) may start only after 120 minutes (GP31).
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: A590, C485, C595, C486, K001

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