Billing code
W155A — Endocrinology consultation – long-term care
Long-term care endocrinology consultation
Bill for an endocrinologist's consultation on a long-term care resident, at a physician's, nurse practitioner's or dental surgeon's written request.
Watch for: Put the referrer's billing number from the written request on the claim; a missing number is rejected.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $172.95 | $0.00 | $0.00 | $0.00 |
- Code
- W155A
- Description
- Endocrinology consultation – long-term care
- 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
Consultation by an endocrinologist for a resident of a long-term care home, chronic care or convalescent hospital, at a referrer's written request.
What it covers
A consultation is an assessment done after a written request from a physician, nurse practitioner or dental surgeon who wants your opinion because of the complexity, seriousness or obscurity of the case, or because the patient asks for another opinion. It includes a written report to the referrer (GP16).
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). A155 is the office code and C155 the hospital in-patient code (A98, A102).
Billing rules
- Needs a written, signed request naming you or the specialty, the referrer and their billing number, and the patient and health number, kept in your chart; otherwise it pays as a lesser assessment (GP16). In a long-term care institution, the request may be on the common medical record (GP16).
- Consultations for the same patient and diagnosis are limited to one per two consecutive 12-month periods (a second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first); an unrelated diagnosis allows one per 12 months. Excess claims pay as an assessment (GP17, GP18).
- Detention (K001) is only payable after 60 minutes (GP29, GP30).
- Patients under 16 get an age premium of 10% to 30%, depending on age (GP64).
- By video only for an in-patient or long-term care resident, and only if you aren't the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within the past 30 days (Appendix J AJ2, A69).
- For emergency calls and other special visits to long-term care patients, bill the General Listings (A-prefix) code with the special visit premium instead (A103, GP49).
Common rejections
- ARP: OHIP needs the referring provider's number on a consultation claim; add the referrer's billing number from the written request and resubmit (GP16).
Related codes: A155, C155, W150, W255, W156
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103; rules GP16–GP18, GP49.
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