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C488

C488Concurrent 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 C488 when you are the consultant providing ongoing directive care for a specific condition while the family physician or another specialist remains the MRP.
  • Use C488 for daily or periodic hospital follow-ups after the initial consultation (A-prefix code) has been completed and the patient remains admitted.

Common Pitfalls

  • Billing C488 when you are the MRP; if you have assumed responsibility for the patient's care, you must bill subsequent hospital visits (C002) instead.
  • Exceeding the weekly limit of 4 claims in the first week or 2 claims thereafter, which will result in automatic rejection by the Ministry.
  • Failing to ensure the referring physician has explicitly requested continued directive care, as this is a mandatory requirement for the validity of the concurrent care designation.

Billing Tips

  • If the patient is located in an ICU or CCU, remember to append the C101 premium to your C488 claim to capture the additional value for critical care settings.
  • Ensure your documentation clearly reflects the request from the MRP for your ongoing involvement to satisfy audit requirements regarding the 'directive care' mandate.
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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