What are the billing rules for G849A?

Marked (+): when the immunization is the sole reason for the visit, add G700, once per patient per day however many vaccines or (+) procedures are given (J3, J54). G700 is not payable in hospital, and is paid at 15% of its fee for patients enrolled to a capitation-based group (J3). May be delegated to trained office staff, even when you aren't on site, for your own patient; the chart must name who gave it (GP62–GP63).

What is G849A often billed with?

G700 when the vaccine is the only reason for the visit (J3, J54). An assessment such as A007 or K030 diabetic management assessment; procedures are payable in addition to an assessment, and G700 isn't added (J3). G846 pneumococcal conjugate given at the same visit, under its own code, with at most one G700 (J3, J54).

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Billing code

G849A — Respiratory syncytial virus (RSV) immunization

Q: What is OHIP billing code G849A?

Immunization with a respiratory syncytial virus (RSV) vaccine. Add G700 when it's the only reason for the visit.

RSV vaccine

Bill G849 for a respiratory syncytial virus vaccine; add G700 when it is the only reason for the visit.

Watch for: For nursing home patients under W010 that month, G849 by any physician isn't payable.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$8.80	$0.00	$0.00	$0.00	$0.00

Code: G849A
Description: Respiratory syncytial virus (RSV) immunization
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

Immunization with a respiratory syncytial virus (RSV) vaccine. Add G700 when it's the only reason for the visit.

What it covers

G849 is the immunization code for a respiratory syncytial virus (RSV) vaccine (J54). Because RSV has its own code, G538 (other immunizing agents not listed) is not used for it (J54).

Billing rules

Marked (+): when the immunization is the sole reason for the visit, add G700, once per patient per day however many vaccines or (+) procedures are given (J3, J54).
G700 is not payable in hospital, and is paid at 15% of its fee for patients enrolled to a capitation-based group (J3).
May be delegated to trained office staff, even when you aren't on site, for your own patient; the chart must name who gave it (GP62–GP63).
Payable on the same day as a counselling service by the same physician (GP58).
For a nursing home or home for the aged patient, G849 is a component of W010 monthly management: when W010 is paid, G849 by any physician that month isn't eligible for payment (GP51–GP52).
The Schedule notes an immunization may be uninsured in some circumstances and refers to section 24 of Regulation 552 under the Health Insurance Act (J54, AA1).
FHO and FHN: a core (in-basket) service from April 1, 2026, including for long-term care enrolled patients (INFOBulletin 260316).

Often billed with

G700 when the vaccine is the only reason for the visit (J3, J54).
An assessment such as A007 or K030 diabetic management assessment; procedures are payable in addition to an assessment, and G700 isn't added (J3).
G846 pneumococcal conjugate given at the same visit, under its own code, with at most one G700 (J3, J54).
FHO: Q012A with an after-hours A007A for an enrolled patient; the after-hours premium is paid on the listed visit codes, not on G849 (Agreement p.68 §8.12).

Related codes: G538, G700, G590, G846, G593

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Injections or Infusions — Immunization, page J54

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