All codes
C068
C068 – Subsequent visits - Nursing home or home for the aged
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Concurrent care (per visit) rendered in hospital by an Orthopaedic Surgeon following their first major assessment of the patient, when the family physician remains the Most Responsible Physician (MRP) but has requested continued directive care by the consultant.
When to Use
- Use C068 when you are an Orthopaedic Surgeon providing directive care for a specific fracture or condition while the patient remains under the primary care of a hospitalist or family physician.
- Use this code for ongoing management of a patient in a hospital setting when you are not the MRP but have been explicitly requested to provide continued directive specialist oversight.
Common Pitfalls
- Billing C068 for patients in palliative care beds will result in automatic rejection; use appropriate palliative care codes instead.
- Confusing C068 with W068 is a frequent audit trigger; ensure C068 is only used for hospital in-patients and never for nursing home or long-term care facility visits.
- Exceeding the frequency limit of 4 visits in the first week or 2 visits per week thereafter will lead to payment clawbacks.
Billing Tips
- If the patient develops a new, unrelated acute condition requiring additional visits, bill C121 in addition to C068 to capture the extra work.
- Ensure your documentation explicitly references the request from the MRP for continued directive care to satisfy audit requirements for concurrent care.
Provider Fee$0.00
Specialist Fee$31.00
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
In-patient
Code Classes
Assessment
Requires a request from the MRP for continued directive care by the consultant.
Concurrent care is distinct from supportive care (where the consultant is not directive).
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