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Billing code

C695A — Neurodevelopmental consultation – hospital in-patient

Adult neurodevelopmental in-patient consultation

Bill for a psychiatric consultation on an adult in-patient with complex neurodevelopmental conditions, with at least 90 minutes with patient and caregiver.

Watch for: One per patient per physician every 5 years; record start and stop times in the chart.

Code

C695A

Description

Neurodevelopmental 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

Psychiatric consultation for a hospital in-patient adult with complex neurodevelopmental conditions, with at least 90 minutes with patient and caregiver.

What it covers

C695 is the in-patient version of A695, on the same conditions (A186). The physician provides all the elements of A195 for an adult with complex neurodevelopmental conditions, for example autism or global developmental disorders (A183).

It must include at least 90 minutes in direct contact with the patient and caregiver, not counting time on other separately billable services (A183).

Billing rules

• Record start and stop times in the patient's permanent record (A183).
• Maximum one per patient per physician every 5 years (A183).
• Consultations for children or adolescents, or for less complex conditions such as attention deficit disorder, are paid at a lesser fee (A183).
• Needs a written, signed request naming you or the specialty, the referrer and their billing number, and the patient and health number, kept in your chart (a common hospital record is fine). Without it OHIP pays a lesser assessment (GP16).
• K630 extension: the first unit starts after 120 minutes with the patient (136 minutes for one unit); maximum 6 units per day (A185).
• Virtual care: video only, not phone (AJ2). For an in-patient you must not be the MRP, the hospital must lack a local physician with the expertise (documented by the referrer), and for a consultation the referrer must have seen the patient in person within 30 days (A69).

Often billed with

• K630 psychiatric consultation extension (A185).

Common rejections

• ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
• AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).

Related codes: A695, W695, C190, C795, C895, K630

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A186. Conditions at A183.

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