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C138
C138 – Concurrent care
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · 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 C138 when you have completed an initial consultation (e.g., C135) and the patient remains under the primary care of the family physician, but you are asked to provide ongoing directive management.
- Use C138 for routine follow-up assessments in hospital when you are not the Most Responsible Physician (MRP) and are not managing an intercurrent illness that would otherwise qualify for C121.
Common Pitfalls
- Billing C138 when you have assumed the role of MRP; in this scenario, you must switch to standard subsequent visit codes like C132, C137, or C139.
- Exceeding the weekly frequency limits of 4 claims in the first week and 2 claims per week thereafter, which will trigger automatic rejections.
- Attempting to bill C138 on the same day as another assessment code by the same physician, which is strictly prohibited by the General Preamble.
Billing Tips
- Ensure the patient's chart explicitly notes the request from the MRP for continued directive care to satisfy audit requirements for the 'concurrent' designation.
- If the patient develops a new, distinct acute condition requiring intensive management, bill C121 instead of C138 to reflect the increased complexity and bypass the concurrent care frequency limits.
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
Concurrent care is defined in General Preamble .
The fee for C138 is $40.05 as per the Numeric Index ().
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