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Billing code

W001A — Additional subsequent visits - 4/month

Extra chronic care hospital visits

Bill for routine visits to a chronic care or convalescent hospital patient after the first 4 (W002) in the month.

Watch for: Maximum 4 W001 per patient per month; bill acute intercurrent illness visits as W121 instead.

Code

W001A

Description

Additional subsequent visits - 4/month

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Routine visit to a chronic care or convalescent hospital patient after the first four that month. Maximum 4 per patient per month.

What it covers

A subsequent visit is any routine assessment after the patient's admission to a long-term care institution (GP49). W001 covers additional subsequent visits after the first four in the month, maximum 4 per patient per month for a patient in a chronic care or convalescent hospital (A19).

W-prefix codes apply to patients in chronic care or convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent beds, but not designated palliative care beds (GP49).

Billing rules

• Maximum 4 W001 per patient per month, after the 4 W002 visits (A19).
• Visits for an acute intercurrent illness that don't need a special visit are billed as W121, whatever the monthly count (GP49).
• If you are already in the institution and see your own patient, use the W-prefix codes; seeing another physician's patient on an emergency basis uses the A-prefix General Listings (GP49).
• Special visit premiums are not payable for elective services in LTC, including routine patients seen on rounds after a non-elective call (GP66).
• FHO: a Schedule 2A code for enrolled LTC patients (Agreement p.86) and counts toward the long-term care special payment (Agreement p.67 §8.10).

Often billed with

• E079 smoking cessation initial discussion (A56).

Common rejections

• AM1: 'Service limit exceeded': more than 4 W001 visits were billed for the patient in the month (A19).

Related codes: W002, W121, W882, W003, W008

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A19; rules GP49.

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