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Billing code

G878A

Guidance for several Botox injections

Bill G878 for EMG or ultrasound guidance to find the sites of two or more botulinum toxin injections.

Watch for: Payable only on the same claim as G870, G873, G874 or G876; use G877 for a single injection.

Code

G878A

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 for EMG and/or ultrasound guidance to find the sites of two or more botulinum toxin injections.

What it covers

G878 is added when EMG and/or ultrasound guidance is needed to find the injection sites for two or more botulinum toxin injections. It is payable with G870, G873, G874 or G876 (J51).

For a single injection, use G877 (J51).

Billing rules

• Payable only with G870, G873, G874 or G876 (J51).
• Other EMG or ultrasound services used to find the injection site are not payable with botulinum toxin services (J52).
• Add E543 for a disposable EMG hypodermic electrode used outside hospital, maximum one per patient per day (J51).

Often billed with

• G876 additional dystonia/spasticity injections (J51).
• E543 disposable EMG electrode outside hospital (J51).

Common rejections

• AD9: OHIP describes this as 'Premium not allowed alone': this add-on must be on the same claim as a payable G870, G873, G874 or G876.

Related codes: G877, E543, G876, G875, G873

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Injections or Infusions, Botulinum Toxin Services, page J51. Payment rules J52.

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