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Billing code

C477A — Respiratory subsequent visit – weeks 6 to 13

Respirology hospital visit, weeks 6–13

Bill for a respirologist's routine hospital visit from the 6th to the 13th week after admission.

Watch for: Maximum 3 per patient per week; bill an extra visit for an acute intercurrent illness as C121 instead.

ProviderSpecialistAssistantAnaesthetistNon-anaesthetist
$0.00$40.05$0.00$0.00$0.00
Code
C477A
Description
Respiratory subsequent visit – weeks 6 to 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 in-hospital follow-up visit by a respirologist from the 6th to the 13th week after admission, up to 3 per week.

What it covers

C477 is a subsequent visit by a specialist in Respiratory Disease to a non-emergency hospital in-patient from the sixth to the thirteenth week inclusive, maximum 3 per patient per week (A199).

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

Billing rules

  • Maximum 3 per patient per week; visits over the limit are not paid (A199, GP43).
  • After 5 weeks, a visit for an acute intercurrent illness beyond the limit is billed as C121, which is not subject to it (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).

Often billed with

  • E083 or E084 MRP subsequent visit premium (GP47).
  • C121 for acute intercurrent illness beyond the limit (GP43).

Common rejections

  • AM1: OHIP's message is 'Service Limit Exceeded': more than 3 visits were billed in the week; use C121 if the extra visit was for an acute intercurrent illness (GP43).

Related codes: C472, C479, C121, E083, E084

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

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