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Billing code

C470A — Comprehensive respiratory disease consultation – hospital in-patient

Comprehensive respirology in-patient consultation

Bill for a respirology consultation on a hospital in-patient with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the chart, or it pays a lesser fee.

Code

C470A

Description

Comprehensive respiratory disease consultation – 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

Comprehensive respirology consultation for a hospital in-patient: a full consultation with at least 75 minutes of direct patient contact.

What it covers

C470 is the in-patient version of A470, on the same conditions (A199). The respirologist provides all the elements of a consultation and spends at least 75 minutes in direct contact with the patient, not counting other separately billable services (A197).

Time excludes non-patient-facing work such as reviewing charts, imaging or documentation (A197 commentary).

Billing rules

• Record start and stop times in the permanent record, or it pays as a lesser fee (A197).
• Needs a written, signed request naming you or the specialty, the referrer and their billing number, and the patient and health number, kept in your chart (a common hospital record is fine). Without it OHIP pays a lesser assessment (GP16).
• Same patient, same diagnosis: one consultation per two consecutive 12-month periods; a second is allowed only for an in-patient or ED patient 12 to 24 months after the first. Excess claims pay as an assessment (GP17, GP18). Comprehensive consultations count toward the limit (GP18).
• Detention (K001) is payable only after 120 minutes (GP31).
• If this is your admission assessment and you are the MRP, E082 (+30%) may be added once per admission; not for transfers within the same hospital (GP42).
• Virtual care: video only, not phone (AJ2). For an in-patient you must not be the MRP, the hospital must lack a local physician with the expertise (documented by the referrer), and for a consultation the referrer must have seen the patient in person within 30 days (A69).

Often billed with

• E082 MRP admission premium when this is the admission assessment (GP42).

Common rejections

• ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
• AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).

Related codes: A470, C475, C575, C476, K001

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A199. Conditions at A197.

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