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Billing code

W121A — LTC visit for acute intercurrent illness

LTC visit, acute intercurrent illness

Bill for a visit to a long-term care patient for an acute intercurrent illness that doesn't need a special visit, whatever the monthly count.

Watch for: If a special visit is needed, bill the A-prefix code with special visit premiums instead.

Code

W121A

Description

LTC visit for acute intercurrent illness

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

LTC visit for an acute intercurrent illness that doesn't need a special visit. Paid whatever the monthly subsequent visit count.

What it covers

W121 is for visits to a long-term care patient for an acute intercurrent illness, other than special visits (GP49).

W121 is payable whenever rendered and doesn't depend on whether the monthly limit on subsequent visits has been reached (GP49).

Billing rules

• If the intercurrent illness needs a special visit, bill the A-prefix General Listings code with the special visit premiums instead (GP49).
• Included in W010 that month, except when you made more than four W assessments and already billed W010 in the past 11 months: extra intercurrent visits are then paid as W121 on top of W010 (GP51, GP52).
• Submit those W121 claims with the manual review indicator (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

• W010 monthly management, under payment rule 7 (GP52).
• E079 smoking cessation initial discussion (A56).

Related codes: W003, W008, W002, W001, W010, C121

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A19; rules GP49, GP51–GP52.

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