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Billing code

C009A — Hospital subsequent visit – after week 13

Hospital visit after week 13

Bill C009 for a family physician's routine in-patient visit after the 13th week of the hospital stay.

Watch for: Maximum 6 per patient per month; bill extra visits for an acute intercurrent illness as C121 instead.

Code

C009A

Description

Hospital subsequent visit – after week 13

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

Routine hospital in-patient visit after the 13th week of the stay. Maximum 6 per patient per month.

What it covers

C009 is the Family Practice subsequent visit code for routine in-patient assessments after the thirteenth week of the hospital stay (A13).

A subsequent visit is any routine assessment in hospital after the admission assessment (GP43).

Billing rules

• Maximum 6 per patient per month; extra visits are not payable (A13, GP43).
• Extra visits for an acute intercurrent illness are billed as C121, which is not subject to the monthly limit (GP43).
• Week counting starts from the date you first assessed a referred patient, or from the actual admission date for a transferred patient (GP43).
• Add E083 (MRP premium) or, on a Saturday, Sunday or holiday, E084, when you are the MRP; only one per patient per day (GP47).
• Qualifies for the automatic hospitalist premium for eligible FPs and internists with high in-patient volumes (GP103).
• Detention (K001) can start only after 30 minutes of a subsequent hospital visit (GP30).
• FHO: counts toward the hospital services special payment (Agreement Schedule 3, p.90; §8.5, p.66). In-patient services to enrolled patients are paid full fee-for-service (Agreement p.64 §7.2).

Often billed with

• E083 or E084 MRP premium (GP47).
• C121 for extra visits due to an acute intercurrent illness (GP43).

Common rejections

• AM1: 'Service limit exceeded': more than 6 subsequent visits were billed for the patient in the month (A13, GP43).

Related codes: C002, C007, C121, E083, E084, C882

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A13; rules GP43.

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