All codes
C188
C188 – Concurrent care
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Subsequent visits per month (maximum of 3 per patient per month) in a nursing home or home for the aged.
When to Use
- Use C188 when you are a specialist providing ongoing directive care for a patient in a nursing home or home for the aged at the request of the MRP.
- Apply this code for follow-up visits after your initial consultation (C003 or equivalent) has been completed and documented.
- Select C188 when managing a specific chronic condition in a long-term care setting where the patient requires periodic specialist oversight alongside the MRP's care.
Common Pitfalls
- Billing more than three C188 services per patient per month will result in automatic rejection of the fourth and subsequent claims.
- Attempting to attach a special visit premium (e.g., A900 series) to C188 will result in a rejection, as concurrent care is considered routine and non-urgent.
- Using C188 without a documented referral or request from the MRP on file creates a significant audit risk for non-compliance with the 'directive care' requirement.
Billing Tips
- Ensure your claim includes the referring physician's billing number to satisfy the requirement for a formal request for concurrent care.
- Coordinate with the MRP to ensure your billing frequency does not exceed the monthly limit, as the system does not track concurrent care claims from different specialists against the same patient cap.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Assessment
Code Classes
Hospital and Institutional Consultations and Assessments
Referral RequiredFrom: Physician
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