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Billing code

G402A — Critical care (intensive care area) – physician-in-charge – 31st day onwards (per diem)

ICU critical care, day 31+

Bill G402 per day as the physician-in-charge of a critically ill patient in an intensive care area, from day 31 onwards.

Watch for: No other critical care codes are payable to you that day; stabilized patients aren't eligible unless ventilated.

Code

G402A

Description

Critical care (intensive care area) – physician-in-charge – 31st day onwards (per diem)

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Critical care per diem for the physician-in-charge of a critically ill patient in an intensive care area, 31st day onwards (per diem).

What it covers

G402 is the critical care fee for the physician-in-charge, 31st day onwards (per diem) (J31). It is marked #, so premises and equipment are hospital funded (J1).

Critical care is all aspects of care of a critically ill patient in an intensive care area, excluding ventilatory support. It includes the initial consultation and assessment, emergency resuscitation, IV lines, cutdowns, intraosseous infusion, arterial, CVP or urinary catheters, nasogastric intubation, lab tests, oximetry and ICP monitoring interpretation (not insertion of the ICP device) (J31).

Billing rules

• These are team fees: claim the daily formula as if there were one physician-in-charge, even if the physician-in-charge changes during treatment (J30).
• When claiming critical, ventilatory, comprehensive or neonatal intensive care fees, no other critical care codes are payable to the same physician(s) (J30).
• Not payable for stabilized patients or patients in the unit only for ECG monitoring or observation, except when the patient is on a ventilator; bill consultations, assessments and procedures instead (J30, J31).
• Bill G402 per day from day 31 onwards, after G400 (day 1) and G401 (days 2–30) (J31).
• If the patient is transferred from comprehensive care to critical care, the transfer day counts as the 2nd day of critical care (J31).
• If the patient was discharged from the unit more than 48 hours earlier and is re-admitted, the 1st-day rate applies again on the day of re-admission (J30).
• Life-threatening (G521/G522/G523) and other critical care (G395/G391) aren't payable to a physician paid a per diem for the same patient that day (J27, J28). C101 ICU/CCU premium is not payable when team fees are claimed (GP103).
• After critical care stops, the usual consultation, assessment and procedure fees apply (J30).

Related codes: G400, G401, G405, G557, G521, G395

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Critical Care, page J31; per diem rules J30.

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