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Billing code

C479A — Respiratory subsequent visit – after week 13

Respirology hospital visit, week 14+

Bill for a respirologist'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

C479A

Description

Respiratory subsequent 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 in-hospital follow-up visit by a respirologist after the 13th week of admission, up to 6 per month.

What it covers

C479 is a subsequent visit by a specialist in Respiratory Disease to a non-emergency hospital in-patient after the thirteenth week, maximum 6 per patient per month (A199).

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

Billing rules

• Maximum 6 per patient per month; visits over the limit are not paid (A199, GP43).
• 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 6 visits were billed in the month; use C121 if the extra visit was for an acute intercurrent illness (GP43).

Related codes: C472, C477, 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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