Billing code
C159A — Endocrinology subsequent hospital visit – after week 13
Endocrinology hospital visit, week 14+
Bill C159 for an endocrinologist's routine in-patient follow-up visit after the 13th week of the stay.
Watch for: Maximum 6 visits per patient per month; bill an acute intercurrent illness visit as C121 instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $40.05 | $0.00 | $0.00 | $0.00 |
- Code
- C159A
- Description
- Endocrinology subsequent hospital 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 follow-up visit by an endocrinologist to a hospital in-patient after the thirteenth week of the stay, up to 6 per month.
What it covers
A subsequent visit is any routine assessment in hospital after the admission assessment (GP43). C159 is for visits after the thirteenth week of the stay (A102).
C152 covers the first five weeks and C157 weeks 6 to 13 (A102).
Billing rules
- Maximum 6 visits per patient per month after week 13; extra visits aren't payable (A102, GP43).
- A visit needed for an acute intercurrent illness beyond the monthly limit is billed as C121, which has no monthly limit (GP43).
- If the patient was referred to you in hospital, count from the date you first assessed them; after a transfer of care, count from the actual admission date (GP43).
- Detention (K001) is only payable after 30 minutes (GP30).
- Not on the virtual care list (Appendix J).
Often billed with
- E083 MRP subsequent visit premium (+30%), or E084 (+45%) on Saturdays, Sundays and holidays (GP47).
Common rejections
- AM1: More than 6 visits in the month after week 13; bill an acute intercurrent illness visit as C121 instead (GP43).
Related codes: C152, C157, C121, C158, E083, E084
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A102; rules GP43, GP47.
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