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C078
C078 – Subsequent visits per month
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
In a Long-Term Care setting (Nursing Home/Home for the Aged), this code represents routine subsequent visits for Geriatrics. In a Hospital In-patient setting, it represents Concurrent Care where a consultant provides directive care while another physician remains the MRP.
When to Use
- Use C078 for the third and subsequent routine monthly visits in a Long-Term Care facility after W073 has been billed for the first two visits.
- Use C078 as a consultant providing ongoing directive care for an in-patient when the MRP is a different physician, provided you remain within the 4-per-week or 2-per-week frequency limits.
Common Pitfalls
- Billing C078 for patients in palliative care beds, which triggers automatic rejection; use C982 or W972 instead.
- Attempting to bill C078 for virtual care services, as this code is strictly limited to in-person encounters.
- Exceeding the monthly LTC limit of 3 visits per patient; visits beyond this threshold require a different clinical justification or code.
Billing Tips
- If a patient develops an acute intercurrent illness that requires an unscheduled visit, switch to W121 rather than C078 to avoid monthly frequency limit rejections.
- Ensure your billing software correctly differentiates between Nursing Home and Chronic Care facilities, as Chronic Care settings require W071/W072 instead of C078.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Subsequent Visit
Code Classes
Assessment
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