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Billing code

E080A — First Post Hospital Premium - within 2 weeks

Post-discharge visit premium

Add to the primary care physician's first office or home visit within 2 weeks of the patient's discharge from an acute care hospital.

Watch for: Not payable after day surgery, routine delivery or well newborn admissions, or in nursing homes and similar settings.

Code

E080A

Description

First Post Hospital Premium - within 2 weeks

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

Premium for the primary care physician's first office or home visit within 2 weeks of the patient's discharge from an acute care hospital.

What it covers

E080 is an add-on for the patient's primary care physician for the first visit after an in-patient admission to an acute care hospital, in the office or the patient's home, within two weeks of discharge (GP28).

Billing rules

• Payable only with: A001, A003, A004, A007, A008, A261, A262, A263, A264, A888, A900, K004–K008, K013, K014, K022, K023, K028–K030, K032, K033, K037, K623, P003, P004, P008 (GP28).
• Only in the physician's office or the patient's home; not in nursing homes, homes for the aged, chronic care hospitals and similar settings (GP28).
• Not payable after an admission for obstetrical delivery unless the mother needed ICU care (GP28).
• Not payable after an admission for newborn care unless the infant needed NICU care (GP28).
• Not payable after day surgery (GP28).
• Payable on a comprehensive virtual visit by video only, at a set amount (A74).

Often billed with

• A007 intermediate assessment, the usual follow-up visit (GP28).
• A900 complex house call for a frail or housebound patient seen at home (GP28).
• K013 counselling, since E080 is on the counselling same-day list (GP28, GP58).
• K023 palliative care support for palliative patients after discharge (GP28).

Common rejections

• AT3: The base visit was billed as comprehensive virtual care with no existing patient-physician relationship on OHIP's record, so the visit and premium were rejected (AT3 guide; A66).
• EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).
• VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
• VH8: The date of birth doesn't match OHIP's record for the health number; correct it and resubmit (VH8 guide).
• VH9: OHIP can't find the health number in its registration records; compare it digit by digit with the card (VH9 guide).

Related codes: A007, A001, A900, K013, K023, A003

Source: Schedule of Benefits (July 1, 2026), General Preamble, First visit by primary care physician after hospital discharge, page GP28; virtual premium on page A74.

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