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Billing code

W156A — Endocrinology repeat consultation – long-term care

LTC endocrinology repeat consultation

Bill for an endocrinologist's repeat consultation on the same problem after another physician has cared for the resident in between.

Watch for: Needs a new written request and the referrer's billing number; if virtual, it must be by video, not phone.

Code

W156A

Description

Endocrinology repeat 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

Repeat consultation by an endocrinologist for a long-term care resident, for the same problem after another physician has given care in between.

What it covers

A repeat consultation is an additional consultation by the same consultant for the same presenting problem, after another physician has cared for the patient since your first consultation. It needs a new written request (GP19).

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

• Needs a new written request; in a long-term care institution it may be on the common medical record (GP16, GP19).
• If the repeat consultation requirements aren't met, it pays as an assessment (GP18).
• Repeat consultations don't count toward the consultation limits (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).

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).
• AT2: This code is on the video-only virtual care list, so it can't be billed by telephone (K301A); bill it only for a video visit with K300A (Appendix J AJ2).

Related codes: A156, C156, W155, W255

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103; rules GP16–GP19.

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