OHIP fee codeC263

Medical specific assessment

CONSULTATIONS AND VISITS · NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES · PAEDIATRICS (26)

$95.75

What this reference tells you

C263 identifies the Ontario insured service described as “Medical specific assessment.” The listed fee and rules are reference data; the clinical record must support the service actually performed.

Loaded billing requirements

This service is not eligible for payment if any other service is rendered by the same physician at the time of the delivery unless the newborn is sick in which case a medical specific assessment (C263) is payable in addition to attendance at maternal delivery...
are required. 13.If an obstetrician who normally cares for newborns him/herself or transfers the care of newborns to a family physician, refers a newborn to a paediatrician because of the complexity, obscurity or seriousness of the case, the latter may claim...

Before using this code

Confirm the current Ministry publication, the patient and provider context, the date of service, and documentation supporting the claim. A searchable reference does not establish eligibility or guarantee payment.

Loaded billing requirements

Before using this code

Take the code from reference to reviewed claim.