G621 – Neonatal intensive care - Level C - 2nd day onwards
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G621 is the per diem fee for the second day and all subsequent days of Level C Neonatal Intensive Care. Level C is defined as intermediate care which includes one or more of: oxygen administration, non-invasive monitoring or gavage feeding. <br><br>The Neonatal Intensive Care fee is a team fee rendered by a physician for being in constant or periodic attendance during a one-day period, providing all aspects of care to patients in an Intensive Care Area. The fee includes an initial consultation or assessment and any subsequent assessments, ongoing monitoring, and necessary procedures such as insertion of arterial, venous, C.V.P. or urinary catheters, intravenous lines, interpreting of blood gases, nasogastric intubation with or without anaesthesia, pressure infusion sets and pharmaceutical agents, endotracheal intubation, tracheal toilet, artificial ventilation and all necessary measures for respiratory support. Separately billable interventions may be claimed in addition to this fee.
When to Use
- Use G621 for the second day and beyond when the neonate requires intermediate care including oxygen, non-invasive monitoring, or gavage feeding.
- Use G621 when a patient is transferred from a higher-level NICU (G601/G604) to a Level C unit, as the second-day benefit applies immediately upon transfer.
Common Pitfalls
- Billing a daily assessment code (e.g., C010) in addition to G621 is a rejection error, as the per diem fee includes all assessments and ongoing monitoring.
- Attempting to bill G621 for the first day of care, which must be claimed using the appropriate Level C initial day code (G620).
Billing Tips
- Ensure that separately billable procedures performed during the NICU stay are submitted with the appropriate diagnostic/therapeutic codes, as these are not bundled into the G621 per diem.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ManagementFee
Diagnostic and Therapeutic Procedures
Service is for neonatal intensive care.
1. Physician-in-charge is the physician(s) daily providing the Neonatal Intensive Care.
2. These are team fees which apply to neonatologists /paediatricians/anaesthetists providing complete care. If infant has been transferred from one level to another in either direction, up or down, second day benefits apply.
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