All codes
C158
C158 – Subsequent visits per month
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A 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 C158 when you are providing ongoing specialty-specific management for a patient admitted under a family physician who remains the MRP.
- Use C158 for follow-up assessments when the primary goal is to provide directive care for a chronic condition already established during your initial consultation.
Common Pitfalls
- Billing C158 when you are the MRP; if you have assumed responsibility for the patient's care, you must use C152, C157, or C159 instead.
- Exceeding the weekly frequency limits of 4 claims in the first week and 2 claims thereafter, which will trigger automatic rejections.
- Attempting to claim C158 alongside Special Visit Premiums or MRP premiums like E083, which are strictly prohibited for concurrent care services.
Billing Tips
- If the patient develops an acute, unrelated intercurrent illness requiring additional visits beyond the weekly limit, bill C121 instead of C158 to ensure payment for the extra services.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
In-patient
Code Classes
Assessment
C158 is specific to specialty 15 (Endocrinology).
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.