What are the billing rules for C609A?

Maximum 6 per patient per month after week 13; visits over the limit are not payable (A80, GP43). An assessment needed for an acute intercurrent illness beyond the monthly limit is billed as C121, which has no weekly or monthly limit (A80, GP43). If the patient was referred to you by another physician in hospital, count weeks from the date you first assessed the patient; if care was transferred to you, count from the actual admission date (GP43).

What is C609A often billed with?

E083 MRP subsequent visit premium (+30%), or E084 on Saturdays, Sundays and holidays (+45%; cardiology is an eligible specialty); only one per patient per day and only when you are the MRP (GP47). C101 ICU/CCU premium for each patient seen on a visit to the ICU or CCU, unless a critical care, ventilatory or comprehensive care team fee is claimed (GP103).

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Billing code

C609A — Cardiology in-patient subsequent visit – after week 13

Q: What is OHIP billing code C609A?

Routine follow-up visit by a cardiologist to a hospital in-patient after the 13th week of the stay, up to 6 per month.

Cardiology hospital visit, week 14+

Bill for a cardiologist's routine hospital visit after the 13th week of the stay.

Watch for: Maximum 6 per patient per month; bill an extra visit for an acute intercurrent illness as C121 instead.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$40.05	$0.00	$0.00	$0.00

Code: C609A
Description: Cardiology in-patient 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 follow-up visit by a cardiologist to a hospital in-patient after the 13th week of the stay, up to 6 per month.

What it covers

C609 is a cardiology subsequent visit to a hospital in-patient after the thirteenth week of the stay, paid per visit (A80).

A subsequent visit is any routine assessment in hospital after the admission assessment. When several physicians in different disciplines are needed, each physician's visit is a subsequent visit (GP43).

Billing rules

Maximum 6 per patient per month after week 13; visits over the limit are not payable (A80, GP43).
An assessment needed for an acute intercurrent illness beyond the monthly limit is billed as C121, which has no weekly or monthly limit (A80, GP43).
If the patient was referred to you by another physician in hospital, count weeks from the date you first assessed the patient; if care was transferred to you, count from the actual admission date (GP43).
Not on the Appendix J virtual care list, so not payable by video or phone (AJ1–AJ3).

Often billed with

E083 MRP subsequent visit premium (+30%), or E084 on Saturdays, Sundays and holidays (+45%; cardiology is an eligible specialty); only one per patient per day and only when you are the MRP (GP47).
C101 ICU/CCU premium for each patient seen on a visit to the ICU or CCU, unless a critical care, ventilatory or comprehensive care team fee is claimed (GP103).

Related codes: C602, C607, C121, C124, C608, E083

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Cardiology (60), page A80; rules GP43–GP47.

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