< Billing codes

Billing code

W131A — Internal medicine LTC subsequent visit – chronic care hospital, additional visits

Extra chronic care internist visits

Bill for an internist's routine chronic care or convalescent hospital visits after the first 4 (W132) in the month.

Watch for: Maximum 6 per patient per month; bill acute intercurrent illness visits as W121 instead.

Code

W131A

Description

Internal medicine LTC subsequent visit – chronic care hospital, additional visits

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

Internal medicine routine follow-up visit in a chronic care or convalescent hospital after the first 4 visits in the month, up to 6 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). In a chronic care or convalescent hospital, the first 4 subsequent visits per patient per month are W132; additional visits are W131, to a maximum of 6 per patient per month (A131).

LTC (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 (A131, GP49).

Billing rules

• Use W131 only after W132 has covered the first 4 subsequent visits that month; W131 is limited to a maximum of 6 per patient per month (A131).
• Subsequent visit limits are the ones printed with each listing (GP49).
• Visits for an acute intercurrent illness are billed as W121 whenever needed, regardless of the monthly limits; if a special visit is needed, use A-prefix General Listings and premiums (GP49).
• W-prefix codes are for your own LTC patients; assessing another physician's patient on an emergency basis uses the A-prefix General Listings (GP49).
• Palliative care visits in this setting are W982, not W131 (A131, GP50).
• Not listed in Appendix J, so it is not payable by video or telephone (A68, AJ1–AJ2).

Common rejections

• AM1: More W131 visits than the maximum of 6 per patient per month were claimed (A131). Use W121 for visits needed for an acute intercurrent illness (GP49).

Related codes: W132, W121, W982, W133, W138, W232, W124

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A131; rules GP49.

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