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Billing code

C268A — Paediatric concurrent care – hospital in-patient

Paediatric concurrent care visit

Bill for a consulting paediatrician's routine hospital visit while the family physician stays the most responsible physician and asks for continued care.

Watch for: Limited to 4 claims in the first week of concurrent care, then 2 per week; extra visits aren't paid.

Code

C268A

Description

Paediatric concurrent care – hospital in-patient

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 in-hospital visit by a consulting paediatrician who keeps directing care while the family physician stays the MRP.

What it covers

Concurrent care is any routine assessment in hospital by the consultant after their first major assessment, when the family physician remains the MRP but asks the consultant to continue directing care (GP48).

C268 is the Paediatrics (26) concurrent care code, billed per visit (A173).

Billing rules

• Limited to 4 claims per week in the first week of concurrent care, then 2 per week. Extra visits are not paid (GP48).
• Only for the consultant after their first major assessment; the family physician must remain the MRP (GP48).
• Non-emergency hospital in-patient service. For emergency calls and other special visits to in-patients, use the General Listings (A prefix) with premiums (A173, GP65–GP78).
• 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).

Common rejections

• AHF: OHIP describes this as 'Concurrent or Supportive Care Same Period': the weekly concurrent care limit (4 in week one, then 2 a week) was likely exceeded (GP48).

Related codes: C262, C265, C318, C121, C982

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

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