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Billing code

G488A

Repeat spasticity injection, extra nerve

Bill G488 with G487 for each additional major nerve in a repeat chemodenervation within 30 days of the last one.

Watch for: It must be on the same claim as a payable G487; beyond 30 days, use G485 and G486 instead.

Code

G488A

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

Add-on to G487 for each additional major nerve in a repeat chemodenervation within 30 days of the last one.

What it covers

Chemodenervation is an injection of an individual peripheral motor nerve with phenol, ethyl alcohol or a similar non-anaesthetic chemical agent to reduce focal spasticity. It may include EMG guidance of the injection(s) (J105).

G488 is added for each additional major nerve and/or its branches the same day in a repeat or additional procedure within 30 days of a previous chemodenervation injection; the first nerve is G487 (J105).

Billing rules

• Add-on to G487 (J105).
• Applies only within 30 days of a previous chemodenervation injection; otherwise use G485 and G486 (J105).
• If anaesthetic agents are used instead of phenol, alcohol or similar agents, bill from the nerve block listings (J105).
• A chemodenervation injection into the same muscle on the same day as botulinum toxin is insured but paid at nil (J105).

Often billed with

• G487 first major nerve, repeat within 30 days (J105).

Common rejections

• AD9: OHIP describes this as 'Premium not allowed alone': this add-on must be on the same claim as a payable G487.

Related codes: G487, G485, G486, G875

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Physical Medicine, Chemodenervation Injection, page J105.

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