Billing code
W138A — Internal medicine LTC subsequent visit – nursing home, additional visits
Extra nursing home internist visits
Bill for an internist's routine nursing home or home for the aged visits after the first 2 (W133) in the month.
Watch for: Maximum 3 per patient per month; bill acute intercurrent illness visits as W121 instead.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $40.05 | $0.00 | $0.00 | $0.00 |
- Code
- W138A
- Description
- Internal medicine LTC subsequent visit – nursing home, 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 nursing home or home for the aged after the first 2 visits in the month, up to 3 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 visits per month are W133; further subsequent visits 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
- Bill W138 after W133 has covered the first 2 subsequent visits that month; maximum 3 W138 per patient per month (A131).
- 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 W972 (A131, GP50).
- Not listed in Appendix J, so it is not payable by video or telephone (A68, AJ1–AJ2).
Common rejections
- AM1: More W138 visits than the maximum of 3 per patient per month were claimed (A131). Use W121 for acute intercurrent illness visits (GP49).
Related codes: W133, W121, W972, W131, W132, W134
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A131; rules GP49.
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