What are the billing rules for C209A?

Maximum 6 per patient per month; extra visits are not payable (A150; GP43). A visit needed for an acute intercurrent illness beyond the monthly limit is C121, which doesn't count toward the limit (GP43; A151). If the patient is referred to you in hospital, the date you first assessed the patient is the 'admission date' for choosing the code. If care is transferred, count from the actual admission date (GP43). For the operating surgeon, count from admission if you admitted the patient, or from the referral date (SP2, §1).

What is C209A often billed with?

E083 when you are the MRP (GP47).

Why is C209A rejected?

A4D: 'Invalid specialty for this service code': these codes are for Obstetrics and Gynaecology (20). Specialists must bill from their own specialty's listings (GP9). AM1: 'Service limit exceeded': more than 6 visits were billed in the month (A150; GP43).

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Billing code

C209A — Obstetrics and gynaecology subsequent hospital visit – after week 13

Q: What is OHIP billing code C209A?

Routine in-hospital visit by an obstetrician-gynaecologist after the 13th week of admission, up to 6 per patient per month.

Obstetrics-gynaecology hospital visit, week 14+

Bill for an obstetrician-gynaecologist's routine hospital visit after the 13th week of admission.

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

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

Code: C209A
Description: Obstetrics and gynaecology subsequent hospital visit – after week 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 in-hospital visit by an obstetrician-gynaecologist after the 13th week of admission, up to 6 per patient per month.

What it covers

C209 is a subsequent visit by an obstetrician-gynaecologist after the thirteenth week of a hospital admission (A150). Subsequent visits are routine hospital assessments after the admission assessment (GP43).

Billing rules

Maximum 6 per patient per month; extra visits are not payable (A150; GP43).
A visit needed for an acute intercurrent illness beyond the monthly limit is C121, which doesn't count toward the limit (GP43; A151).
If the patient is referred to you in hospital, the date you first assessed the patient is the 'admission date' for choosing the code. If care is transferred, count from the actual admission date (GP43). For the operating surgeon, count from admission if you admitted the patient, or from the referral date (SP2, §1).
When you are the MRP, bill C122 and C123 on the first two days after the admission assessment and C124/C126 on the day of discharge (A150; GP44–GP45). E083 (+30%) can be added to the MRP's subsequent visits (GP47).
E084 weekend and holiday MRP premium is not payable to specialty 20; its list of eligible specialties doesn't include obstetrics and gynaecology (GP47, rule 3).
Not on the Appendix J virtual care lists, so not payable as virtual care (AJ1–AJ2).

Often billed with

E083 when you are the MRP (GP47).

Common rejections

A4D: 'Invalid specialty for this service code': these codes are for Obstetrics and Gynaecology (20). Specialists must bill from their own specialty's listings (GP9).
AM1: 'Service limit exceeded': more than 6 visits were billed in the month (A150; GP43).

Related codes: C202, C207, C121, C208, E083, C124

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Obstetrics and Gynaecology (20), page A150.

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