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Billing code

W074A — Geriatric nursing home general re-assessment

Nursing home re-assessment, geriatrics

Bill for a geriatrician's general re-assessment of a nursing home resident required by the Nursing Homes Act.

Watch for: Claim it only 6 months after the periodic health visit (W279); limit is 2 re-assessments per patient per 12 months.

Code

W074A

Description

Geriatric nursing home general re-assessment

FHO+ basket

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

Effective date

Jun 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

General re-assessment of a nursing home resident under the Nursing Homes Act, at least 6 months after the periodic health visit.

What it covers

W074 is the Geriatrics (07) general re-assessment of a patient in a nursing home, as required by the Nursing Homes Act (A122).

A general re-assessment includes everything in a general assessment, but the history can be shorter where details are already on file (GP22).

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).
• May only be claimed 6 months after the periodic health visit (W279), as per the Nursing Homes Act (A122).
• General re-assessments are limited to 2 per patient per physician per 12 months, except for hospital admissions; extras pay a lesser fee (GP22).
• In a nursing home or home for the aged, this service is part of W010 monthly management. If you are the MRP billing W010 for the month, don't bill it separately (GP51–GP52).
• Not on the Appendix J virtual care list, so it is not payable by video or phone (AJ1–AJ3).

Related codes: W279, W272, W277, W073, W078, W010

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

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