What are the billing rules for C067A?

Maximum 3 per patient per week in weeks 6 to 13; visits over the limit are not payable (A164, GP43). For the operating surgeon, weeks are counted from the admission date if you admitted the patient, or from the referral date if the patient was referred to you in hospital (SP2, GP43). After 5 weeks, a visit for an acute intercurrent illness beyond the weekly or monthly limits is billed as C121 (GP43).

What is C067A often billed with?

E083 MRP premium (GP47). C121 for acute intercurrent illness beyond the limit (GP43).

Why is C067A rejected?

AM1: OHIP describes this as 'Service limit exceeded': more than 3 subsequent visits in a week during weeks 6 to 13 (A164, GP43).

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Billing code

C067A — Orthopaedic in-patient subsequent visit – weeks 6 to 13

Q: What is OHIP billing code C067A?

Routine hospital visit by an orthopaedic surgeon in weeks 6 to 13 after admission, up to 3 per patient per week.

Orthopaedic hospital visit, weeks 6–13

Bill C067 for an orthopaedic surgeon's routine in-patient visit in weeks 6 to 13 after admission.

Watch for: Maximum 3 per patient per week; bill extra visits for an acute intercurrent illness as C121.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$31.00	$0.00	$0.00	$0.00

Code: C067A
Description: Orthopaedic in-patient subsequent visit – weeks 6 to 13
FHO+ basket: Not in the FHO+ base rate basket (Schedule 2 or 2B).
Effective date: Jun 1, 2025
Termination date: No end date

Explanation

Updated October 26, 2026

Routine hospital visit by an orthopaedic surgeon in weeks 6 to 13 after admission, up to 3 per patient per week.

What it covers

C067 is the Orthopaedic Surgery (06) subsequent visit from the sixth to the thirteenth week of a hospital stay inclusive, with a maximum of 3 per patient per week (A164). A subsequent visit is any routine assessment in hospital after the admission assessment (GP43).

Billing rules

Maximum 3 per patient per week in weeks 6 to 13; visits over the limit are not payable (A164, GP43).
For the operating surgeon, weeks are counted from the admission date if you admitted the patient, or from the referral date if the patient was referred to you in hospital (SP2, GP43).
After 5 weeks, a visit for an acute intercurrent illness beyond the weekly or monthly limits is billed as C121 (GP43).
Seeing another physician's patient on an emergency basis uses the General Listings (A-prefix) (GP43).
As the MRP, add E083 (+30%). E084 (weekend/holiday MRP premium) is not available to Orthopaedic Surgery (06) (GP47).
Not a virtual care code: C067 isn't in Appendix J (AJ1–AJ3).

Often billed with

E083 MRP premium (GP47).
C121 for acute intercurrent illness beyond the limit (GP43).

Common rejections

AM1: OHIP describes this as 'Service limit exceeded': more than 3 subsequent visits in a week during weeks 6 to 13 (A164, GP43).

Related codes: C062, C069, C068, C121, E083

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Orthopaedic Surgery (06), page A164. Subsequent visit rules GP43–GP47.

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