H001 – Newborn care in hospital and/or home
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
H001 is the routine care of a well newborn for up to the first ten days of life in hospital or home and includes an initial general assessment and subsequent assessments, as may be indicated, and instructions to the caregiver(s) regarding the newborn's health care.
When to Use
- Use H001 for the daily routine assessment of a healthy newborn during the initial hospital stay, including the discharge examination.
- Use H001 for home visits conducted within the first ten days of life for a well newborn, provided the service includes a general assessment and caregiver education.
- Use H001 when a newborn is transferred to a second hospital, as the fee is payable to physicians at both facilities in this specific scenario.
Common Pitfalls
- Billing H001 in addition to a standard hospital visit code (A003) is a duplicate billing error; H001 is intended to be the comprehensive service for the newborn.
- Attempting to bill H001 beyond the ten-day limit will result in an automatic rejection; switch to appropriate age-based visit codes for subsequent care.
- Claiming a standard Special Visit Premium (e.g., K962) with H001 is often rejected unless the specific criteria for the discharge-related premium are met.
Billing Tips
- If you are called back to the hospital specifically to discharge a newborn outside of your regular rounds, append the Special Visit Premium for discharge to the H001 claim to ensure proper compensation.
- Ensure the date of birth is correctly registered in the system, as H001 claims are strictly validated against the patient's age in days.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments, Hospital and Institutional Consultations and Assessments
Service is for routine care of a newborn for up to the first ten days of life.
Payment rules: Newborn care is limited to a maximum of one per patient except when a well baby is transferred to another hospital in which case the fee for newborn care may be payable to a physician at both hospitals.
Commentary: An example where this is possible is if the transfer occurred because of the state of health of the mother.
Payment rules: Despite the requirement that to be eligible for a special visit premium the call be non-elective (see ), a special visit premium is payable in addition to this service if a physician is required to make an additional visit to the hospital outside of his or her normally scheduled hospital rounds to facilitate discharge of the newborn the same day as the visit.
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