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Billing code

C319A — Physiatry subsequent hospital visit – after week 13

Physiatry hospital visit, week 14+

Bill for a physiatrist'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.

Code

C319A

Description

Physiatry 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 physiatrist visit to a hospital in-patient after the 13th week of admission. Maximum 6 per patient per month.

What it covers

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

C319 is the Physical Medicine & Rehabilitation (31) subsequent visit after the thirteenth week, billed per visit (A178).

Billing rules

• Maximum 6 per patient per month; extras are not paid (A178, GP43).
• Visits for an acute intercurrent illness beyond the monthly limit are billed as C121, which is outside the limit (GP43).
• If the patient was referred to you in hospital, count weeks from the date you first assessed them; after a transfer of care, count from the actual admission date (GP43).
• E083 (+30%) applies when you are the MRP; E084 (+45%) instead on Saturdays, Sundays and holidays. Only one per patient per day (GP47).
• If you move from these in-patient codes to the rehabilitation unit codes (H312, H317, H319) for the same course of rehabilitation, the weekly and monthly limits apply to the total; you cannot restart the count under the H codes (A180).

Often billed with

• E083 MRP subsequent visit premium (GP47).
• E084 weekend or holiday MRP premium (GP47).

Common rejections

• AM1: OHIP describes AM1 as 'Service Limit Exceeded': more than 6 C319 visits for this patient in the month (A178).
• AH8: OHIP describes this as 'Invalid Admission Date and/or Hospital number'. Subsequent-visit codes depend on weeks since admission, so check the admission date and hospital number on the claim (GP43).

Related codes: C312, C317, C121, H319, C318

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Physical Medicine & Rehabilitation (31), page A178.

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