Billing code
W158A — Endocrinology subsequent visit – nursing home, additional visits
Extra nursing home visits, endocrinology
Bill for an endocrinologist's routine nursing home or home for the aged visits after the first 2 (W153) 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
- W158A
- Description
- Endocrinology 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
Additional routine visits by an endocrinologist to a nursing home or home for the aged resident after the first 2 in a month, up to 3 per month.
What it covers
A long-term care subsequent visit is any routine assessment after the patient's admission to the institution; its limits are those listed with each code (GP49).
W158 is for subsequent visits after the first 2 in the month (W153), in a nursing home or home for the aged (A103).
Billing rules
- Maximum of 3 per patient per month (A103).
- Use W153 for the first 2 visits of the month (A103).
- Visits for an acute intercurrent illness are billed as W121, whatever the monthly count; if a special visit is needed, use the A-prefix code with premiums (GP49).
- Seeing your own resident while already in the home is a W-prefix visit; seeing another physician's patient on an emergency basis uses the General Listings (A-prefix) (GP49).
- Not on the virtual care list, so not payable by video or phone (Appendix J).
Common rejections
- AM1: More than the monthly maximum of W158 visits for the patient; bill an acute intercurrent illness visit as W121 instead (A103, GP49).
Related codes: W153, W121, W152, W151
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103; rules GP49.
APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing