C198 – Concurrent Care
OHIP Surgical Procedures Code — Psychiatry (19) · 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. Source: :<PDFPageNumber>62`.
When to Use
- Use C198 when you are the consultant psychiatrist providing ongoing, routine follow-up care for an inpatient where the family physician or another specialist remains the Most Responsible Physician (MRP).
- Use this code for daily or periodic psychiatric assessments after the initial consultation (A195) has been completed and documented.
Common Pitfalls
- Billing C198 on the same day as a consultation (A195) or a subsequent visit (A190-A198) will result in a rejection for duplicate service.
- Claiming C198 when you are the MRP is incorrect; C198 is strictly for directive care provided by a consultant while another physician holds the MRP status.
- Exceeding the weekly frequency limits for concurrent care will trigger automatic payment adjustments or rejections.
Billing Tips
- Ensure the request for continued directive care from the MRP is clearly noted in the patient's hospital chart to justify the transition from a consultation to concurrent care.
- If the patient is located in an ICU or CCU, remember to append the C101 premium to the C198 claim to capture the additional facility-based fee.
Effective: June 1, 2025
Consultations and Visits
Psychiatry (19)
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
The 'C' prefix indicates the service is for non-emergency hospital in-patients. Source: :.
For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable. Source: :.
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