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G849
G849 – Respiratory Syncytial Virus (RSV) vaccine
OHIP Diagnostic & Therapeutic Procedures Code · Schedule of Benefits
Respiratory Syncytial Virus (RSV) vaccine immunization service.
When to Use
- Bill G849 in conjunction with an assessment code (e.g., A007) when the RSV vaccine is administered during a visit for other clinical concerns.
- Bill G849 with G700 when the patient presents specifically for the RSV immunization and no other assessment or consultation is performed.
Common Pitfalls
- Billing G700 alongside an assessment code (e.g., A007) for the same patient on the same day will trigger a rejection, as G700 is only for visits where the immunization is the sole service.
- Attempting to bill G700 for an RSV vaccine administered in a hospital setting is ineligible and will result in a claim adjustment.
- Failing to document the name of the nurse or non-physician staff member who administered the vaccine, which is a specific requirement for delegated procedures under GP62.
Billing Tips
- Ensure G849 is always appended to the primary visit code to capture the $8.80 fee, as it is an add-on procedure code and not a standalone visit code.
Provider Fee$8.80
Effective: April 1, 2026
Service Type
Immunization
Code Classes
Procedure
For delegated procedures, the medical record must be dated, identify the non-physician performing the service, and contain a brief note on the procedure performed ().
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