< Billing codes

Billing code

W072A — Geriatric chronic care subsequent visit – first 4 per month

Chronic care visit, geriatrics

Bill for a geriatrician's first 4 routine visits per patient per month in a chronic care or convalescent hospital.

Watch for: Further visits that month are W071; not payable by video or phone.

Code

W072A

Description

Geriatric chronic care subsequent visit – first 4 per 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 geriatric visit to a chronic care or convalescent hospital patient: the first 4 subsequent visits per patient per month.

What it covers

W072 is the Geriatrics (07) subsequent visit in a chronic care or convalescent hospital, for the first 4 subsequent visits per patient per month (A122). A subsequent visit is any routine assessment after the patient's admission to the long-term care institution (GP49).

Long-term care (W-prefix) services cover chronic care and convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent beds, but not patients in designated palliative care beds (GP49).

Billing rules

• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Geriatrics (07) (GP9).
• Covers the first 4 subsequent visits per patient per month; additional routine visits are W071, up to 6 per month (A122).
• Visits for an acute intercurrent illness are W121 and are payable whenever done, regardless of the monthly limit. If the illness needs a special visit, use the General Listings (A-prefix) and premiums (GP49).
• When you are already in the institution and see your own patient, use the W-prefix subsequent visit; seeing another physician's patient on an emergency basis uses the General Listings (GP49).
• Special visit premiums are not payable for elective visits in long-term care, or for routine patients seen on rounds (GP65–GP66).
• W010 monthly management applies to nursing home and home for the aged patients, not chronic care or convalescent hospital patients (GP51).
• Not on the Appendix J virtual care list, so it is not payable by video or phone (AJ1–AJ3).

Common rejections

• AM1: OHIP describes this as 'Service limit exceeded': more subsequent visits in the month than this code allows (A122).

Related codes: W071, W121, W982, W073, W124

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A122. LTC subsequent visits GP49.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing