C098 – Concurrent care
OHIP Surgical Procedures Code — CARDIAC SURGERY (09) · Schedule of Benefits
Concurrent care is any routine assessment rendered in hospital by the consultant following the consultant’s first major assessment of the patient when the family physician remains the most responsible physician but the latter requests continued directive care by the consultant.
When to Use
- Use C098 when you are providing ongoing directive cardiac surgical care for an inpatient who remains under the primary management of a hospitalist or family physician.
- Use C098 for routine follow-up assessments after your initial consultation (C091) when the patient is not yet ready for discharge but does not require an acute intervention.
Common Pitfalls
- Billing C098 while simultaneously claiming E083 or E084 is a common rejection, as these premiums are strictly reserved for the Most Responsible Physician (MRP).
- Failing to document the request for directive care from the MRP in the patient chart will lead to clawbacks during an audit, as this is a mandatory requirement for concurrent care.
- Confusing C098 with C010; C098 is for directive surgical management, whereas C010 is for supportive liaison care.
Billing Tips
- Ensure your billing software or service tracks the 'admission date' specifically as the date of your first assessment, as this triggers the sliding scale of visit frequency limits for C098.
Effective: June 1, 2025
A. Consultations and Visits
CARDIAC SURGERY (09)
Non-Emergency Hospital In-Patient Services
Assessment
The family physician (or other physician) must remain the Most Responsible Physician (MRP).
The MRP must request continued directive care by the consultant.
The service must be a routine assessment following the consultant's first major assessment.
Concurrent care is distinct from supportive care (C010), which is rendered by a family physician at the request of the patient/family for liaison or reassurance when the patient is under the care of another physician.
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