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Billing code

W154A — General Re-assessment Of Patient In Nursing Home (as Per The Nursing Homes Act)*

Nursing home re-assessment, endocrinology

Bill for an endocrinologist's general re-assessment of a nursing home patient required by the Nursing Homes Act.

Watch for: Claim it only 6 months after the periodic health visit (W259); limit is 2 re-assessments per patient per 12 months.

Code

W154A

Description

General Re-assessment Of Patient In Nursing Home (as Per The Nursing Homes Act)*

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Jun 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

General re-assessment of a nursing home patient by an endocrinologist under the Nursing Homes Act, claimable 6 months after the periodic health visit.

What it covers

W154 is a general re-assessment of a patient in a nursing home, as set out in the Nursing Homes Act (A103).

A general re-assessment includes everything in a general assessment, except the history need not repeat details already obtained (GP22). W-prefix codes are for non-emergency care in chronic care and convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent beds, but not designated palliative care beds (A103, GP49).

Billing rules

• May only be claimed 6 months after the periodic health visit (W259) (A103).
• General re-assessments are limited to two per patient per physician per 12 months, except for hospital admissions; excess claims pay a lesser fee (GP22).
• Not on the virtual care list, so not payable by video or phone (Appendix J).

Related codes: W259, W257, W153, W158

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103; rules GP22.

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