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Billing code

C472A — Respiratory subsequent visit – weeks 1 to 5

Respirology hospital visit, weeks 1–5

Bill for a respirologist's routine hospital visit after the admission assessment, during the first five weeks after admission.

Watch for: One per patient per day; as the most responsible physician, bill C122, C123 and the discharge codes on those days instead.

Code

C472A

Description

Respiratory subsequent visit – weeks 1 to 5

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 follow-up visit by a respirologist during the first five weeks after admission, one per day.

What it covers

C472 is a subsequent visit by a specialist in Respiratory Disease to a non-emergency hospital in-patient during the first five weeks (A199).

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

Billing rules

• Subsequent visits are routine hospital assessments after the admission assessment. Limits: one per day for weeks 1–5, 3 per week for weeks 6–13, 6 per month after week 13; visits over the limit are not paid (GP43).
• C472 is limited to one per patient per day (GP43).
• When an in-patient is referred to you, the date you first assessed the patient counts as the admission date; after a transfer of care, count from the actual admission date (GP43).
• If you are the MRP, add E083 (+30%), or E084 (+45%) on Saturdays, Sundays and holidays; one per patient per day (GP47).
• Not on the Appendix J virtual care lists, so it can't be billed virtually (AJ1–AJ2).
• The MRP bills C122 and C123 on the first and second days after admission and C124 or C126 on the day of discharge (A199, GP44–GP45).

Often billed with

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

Related codes: C477, C479, C122, C123, C124, C121, E083

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A199. Rules GP43–GP47.

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