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C097 – Subsequent visit - sixth to thirteenth week

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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A routine assessment in hospital or a non-emergency long-term care facility following the hospital admission assessment, rendered between the sixth and thirteenth week (inclusive) of the patient's stay.
The service must be a routine assessment following the initial admission assessment.
If the physician is the Most Responsible Physician (MRP), specific MRP codes (C122, C123, C124) apply for the initial days and discharge; C097 is used for the subsequent routine visits during weeks 6-13.
Usage limits
Maximum 3 visits per patient per week.
C092Subsequent visit - first five weeksC099Subsequent visit - after thirteenth weekC121Additional visits due to intercurrent illnessW095Long-term care consultation

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, and Homes for the Aged.

The weekly limit of 3 visits applies from the start of the 6th week to the end of the 13th week of hospitalization.

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