C199 – Subsequent Visit - After Thirteenth Week
OHIP Surgical Procedures Code — Psychiatry (19) · Schedule of Benefits
This service represents a routine assessment for a hospital in-patient by a psychiatrist, performed after the 13th week of the patient's admission. As a subsequent visit, it follows the initial admission assessment and is part of the ongoing care for the patient. As defined in , a subsequent visit is any routine assessment in hospital following the hospital admission assessment. It includes all the specific elements of assessments as described in , such as a direct physical encounter, history taking, physical examination as appropriate, arranging for related assessments or therapy, and providing advice to the patient or their representative. This service is for non-emergency in-patient services in an acute care hospital, as indicated by the 'C' prefix ().
When to Use
- Use for routine psychiatric follow-up assessments for an inpatient who has been hospitalized for more than 13 weeks.
- Use as the standard daily visit code for long-stay psychiatric patients when no acute intercurrent illness requiring C121 is present.
Common Pitfalls
- Billing C199 more than 6 times per month, as this exceeds the maximum frequency allowed for this specific code.
- Attempting to bill C199 in conjunction with special visit premiums, which are strictly reserved for 'A' prefix codes and not routine hospital rounds.
- Failing to account for the patient's original admission date when calculating the 13-week threshold, even if you recently assumed care of the patient.
Billing Tips
- Always append the E083 premium if you are the Most Responsible Physician (MRP) and meet the hospital remuneration attestation requirements to increase the fee by 30%.
- If an acute intercurrent illness arises that requires an additional visit beyond the weekly or monthly limits, switch to C121 rather than attempting to force an additional C199.
Effective: June 1, 2025
Consultations and Visits
Psychiatry (19)
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
Subsequent visits
after thirteenth week (maximum 6 per patient per month) per visit
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