< Billing codes

Billing code

C775A — Comprehensive Geriatric Consultation - Subject To The Same Conditions As A775

Comprehensive geriatric in-patient consultation

Bill for a geriatrics-certified physician's in-patient consultation of 75 minutes or more, for patients 65 and older or any dementia assessment.

Watch for: Record start and stop times, or it isn't payable; only once per patient per consultant in 2 years.

Code

C775A

Description

Comprehensive Geriatric Consultation - Subject To The Same Conditions As A775

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 geriatric consultation for a hospital in-patient: 75+ minutes of direct contact, for patients 65+ or any patient assessed for dementia.

What it covers

C775 is the in-patient version of A775 and has the same conditions (A121). It is a consultation by a physician with a certificate of special competence in Geriatrics, for a patient at least 65 or for the assessment of dementia, with at least 75 minutes of direct patient contact (A118).

Hospital in-patient (C-prefix) services follow GP40–GP48. For emergency calls and other special visits to in-patients, use the General Listings and special visit premiums instead (A121).

Billing rules

• Must be done by a physician with a certificate of special competence in Geriatrics, for a patient at least 65 years old or, at any age, when the consultation is to assess dementia (A118).
• At least 75 minutes of direct patient contact. Time counts only direct contact with the patient. It excludes other separately paid services and non-patient-facing work such as chart, imaging or documentation review (A119, GP20).
• Record start and stop times in the patient's permanent medical record, or it is not payable (A118).
• Payable only if the same consultant hasn't provided this service to the same patient in the previous 2 years (A118).
• Needs a written, signed request from a physician or nurse practitioner that names you or your specialty, the referrer and their billing number, and the patient and health number. Without it, OHIP pays a lesser assessment (GP16).
• Detention (K001) can be added only after 120 minutes (GP30–GP31).
• Video only (not phone), and for a hospital in-patient or LTC resident only if you are not the MRP, the facility has no physician with the needed expertise (documented by the referrer), and the referrer saw the patient in person within the past 30 days (AJ2, A69).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: C770, C075, A775, W775, C375, C076

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A121. Same conditions as A775 (A118).

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