What are the billing rules for C605A?

The written request can be on the hospital's common medical record; if requirements aren't met it is paid as a lesser assessment (GP16). Consultation limits apply: same diagnosis, one per two consecutive 12-month periods, with a second allowed for an in-patient or ED patient 12 to 24 months after the first (GP17). Only one consultation or assessment is payable per admission when the patient is transferred between physicians in the same hospital (GP40).

Why is C605A rejected?

ARF: 'Missing physician referring number': a consultation claim needs the referring provider's billing number (GP16). AT2: 'Must include video modality': this consultation is video-only as virtual care; it can't be billed by phone (Appendix J AJ2).

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Billing code

C605A — Cardiology in-patient consultation

Q: What is OHIP billing code C605A?

Cardiology consultation for a hospital in-patient, on a written request from a physician or nurse practitioner.

Cardiology in-patient consultation

Bill when a cardiologist consults on a non-emergency hospital in-patient on a written request from a physician or nurse practitioner.

Watch for: Include the referrer's billing number; only one consultation or assessment is paid per admission when the patient moves between physicians.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$188.45	$0.00	$0.00	$0.00

Code: C605A
Description: Cardiology in-patient 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

Cardiology consultation for a hospital in-patient, on a written request from a physician or nurse practitioner.

What it covers

C605 is the cardiology (60) consultation for non-emergency hospital in-patients (A80). A consultation follows a written request and includes a written report with findings, opinions and recommendations to the referring provider (GP16).

If you consult in the ED or out-patient department and then admit the patient, that consultation is the admission assessment (GP40).

Billing rules

The written request can be on the hospital's common medical record; if requirements aren't met it is paid as a lesser assessment (GP16).
Consultation limits apply: same diagnosis, one per two consecutive 12-month periods, with a second allowed for an in-patient or ED patient 12 to 24 months after the first (GP17).
Only one consultation or assessment is payable per admission when the patient is transferred between physicians in the same hospital (GP40).
Patients under 16: specialist consultations get an automatic age premium (GP64).
Video only as virtual care; for in-patients the virtual physician must not be the MRP and the referrer must have assessed the patient in person within 30 days (Appendix J AJ2, A69).

Common rejections

ARF: 'Missing physician referring number': a consultation claim needs the referring provider's billing number (GP16).
AT2: 'Must include video modality': this consultation is video-only as virtual care; it can't be billed by phone (Appendix J AJ2).

Related codes: A605, C600, C675, C606, C603, C602

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Cardiology (60), page A80; rules GP16–GP17, GP40.

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