Billing code
C121A — Hospital visit for acute intercurrent illness
Extra visit for acute illness
Bill C121 for an extra in-patient visit after week 5 because of an acute intercurrent illness, beyond the usual visit limits.
Watch for: Only for visits beyond the C007 or C009 limits after 5 weeks; document the intercurrent illness that required it.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $40.05 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- C121A
- Description
- Hospital visit for acute intercurrent illness
- 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
Extra hospital in-patient visit for an acute intercurrent illness after the fifth week, outside the usual weekly or monthly visit limits.
What it covers
After 5 weeks in hospital, an assessment needed because of an acute intercurrent illness, beyond the weekly or monthly subsequent visit limits, is billed as C121 (GP43).
The weekly and monthly limits that apply to C007 and C009 do not apply to C121 (GP43).
Billing rules
- Only after 5 weeks of hospitalization, and only for visits in excess of the C007/C009 limits caused by an acute intercurrent illness (GP43).
- Document the intercurrent illness that made the extra visit necessary (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).
- 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).
Related codes: C007, C009, C002, E083, E084, W121
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A13; rules GP43.
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