Billing code
W003A — First 2 visits/month
Routine nursing home visit
Bill for the first 2 routine visits per patient per month to a nursing home or home for the aged resident.
Watch for: Don't bill it separately when the most responsible physician bills the W010 monthly management fee for that month.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $40.05 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- W003A
- Description
- First 2 visits/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 nursing home or home for the aged resident: the first 2 subsequent visits 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). W003 covers the first 2 subsequent visits per patient per month for a patient in a nursing home or home for the aged (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
- Bill the first 2 subsequent visits per patient per month as W003; further visits are W008, maximum 2 per patient per month (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).
- Included in W010 when the MRP bills the monthly management fee for that month; don't bill it separately then (GP51, GP52).
- 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).
Related codes: W008, W121, W010, W872, W002, W001
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A19; rules GP49.
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