Billing code
W109A — LTC periodic health visit
Long-term care periodic health visit
Bill for the periodic health visit of a patient in a long-term care institution, such as a nursing home.
Watch for: Don't bill it separately when the most responsible physician bills W010 for that month.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $72.35 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- W109A
- Description
- LTC periodic health visit
- 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
Periodic health visit for a patient in a long-term care institution, such as a nursing home or home for the aged.
What it covers
W109 is the periodic health visit listed for long-term care in-patients (A19). The Schedule treats W109 as a general assessment for the age premium (GP64).
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
- W004 (general re-assessment) may be claimed 6 months after the periodic health visit, per the Nursing Homes Act (A19).
- Patients 65 and over: the fee is increased by 15% automatically (GP64).
- 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: W004, W102, W010, K132, W003
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A19.
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