< Billing codes

Billing code

C262A — Paediatric subsequent hospital visit

Paediatric hospital visit

Bill for a paediatrician's routine hospital visit after the admission assessment, for the whole admission.

Watch for: One per patient per day; it's refused if an MRP visit (C122, C123, C124) was already paid that day.

Code

C262A

Description

Paediatric subsequent hospital visit

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 paediatric visit to a hospital in-patient after the admission assessment. One per patient per day for the whole admission.

What it covers

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

C262 is the Paediatrics (26) subsequent visit, billed per visit (A173).

Billing rules

• Limited to one per patient per day for the whole admission (GP43).
• Seeing your own patient, or one transferred to you, while already in hospital is a subsequent visit; seeing another physician's patient on an emergency basis uses the General Listings (A prefix) (GP43).
• The MRP bills C122 and C123 for the first two days after admission and C124 or C126 on the day of discharge instead, when their rules are met (A173, GP44, GP45).
• E083 (+30%) applies when you are the MRP; E084 (+45%) instead on Saturdays, Sundays and holidays. Only one per patient per day (GP47).
• C121 is used for additional visits due to an intercurrent illness (A173, GP43).
• For a patient 18 or older, a paediatrician is paid only if they saw the patient from the Paediatrics general listings in the 12 months before the 18th birthday, ongoing management of a chronic condition is needed and the patient is under 22, or the MOH gave written prior approval (A168).

Often billed with

• E083 MRP subsequent visit premium (GP47).
• E084 weekend or holiday MRP premium; Paediatrics (26) is an eligible specialty (GP47).

Common rejections

• AO3: OHIP describes this as 'Most Responsible Physician (MRP) Visit Already Paid'. Check whether an MRP visit code (C122, C123, C124) was already paid for that day (GP44).

Related codes: C122, C123, C124, C121, C268, C982

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Paediatrics (26), page A173.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing