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Billing code

W133A — Internal medicine LTC subsequent visit – nursing home, first 2 visits in the month

Nursing home visit, internal medicine

Bill for an internist's first 2 routine visits per patient per month in a nursing home or home for the aged.

Watch for: Bill later visits that month as W138; a third W133 in the month is rejected.

Code

W133A

Description

Internal medicine LTC subsequent visit – nursing home, first 2 visits in the 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

Internal medicine routine follow-up visit to a patient in a nursing home or home for the aged: the first 2 subsequent visits 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 nursing home or home for the aged, the first 2 subsequent visits per patient per month are W133; later visits that month are W138, to a maximum of 3 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

• W133 covers the first 2 subsequent visits per patient per month; bill further visits that month as W138 (maximum 3) (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 a nursing home or home for the aged are W972 (A131, GP50).
• Not listed in Appendix J, so it is not payable by video or telephone (A68, AJ1–AJ2).

Common rejections

• AC1: The monthly maximum for W133 (first 2 visits) was reached; resubmit later visits that month as W138 (A131).

Related codes: W138, W121, W972, W131, W132, W134, W239

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

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