What are the billing rules for W252A?

If you did a consultation, general assessment or general re-assessment of the patient before admission, payment is reduced to a lesser fee; bill Type 2 (W254) instead (GP49). Use Type 3 (W257) for a re-admission after a stay of at least 3 days in another institution (GP49). General assessments are limited to one per patient per physician per 12 months, or two if the diagnosis is clearly different or at least 90 days have passed and the second is a hospital admission assessment (GP21).

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Billing code

W252A — Endocrinology long-term care admission assessment – Type 1

Q: What is OHIP billing code W252A?

General assessment by an endocrinologist of a patient on admission to a long-term care institution, when you haven't assessed them before admission.

LTC admission, endocrinology, Type 1

Bill for an endocrinologist's general assessment on long-term care admission when you haven't assessed the patient before admission.

Watch for: If you consulted or assessed before admission, bill Type 2 (W254); re-admissions after 3+ days elsewhere are W257.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$69.35	$0.00	$0.00	$0.00

Code: W252A
Description: Endocrinology long-term care admission assessment – Type 1
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 assessment by an endocrinologist of a patient on admission to a long-term care institution, when you haven't assessed them before admission.

What it covers

A Type 1 admission assessment is a general assessment of a patient on admission to a long-term care institution (GP49).

A general assessment needs a full history (presenting complaint, family, past and social history, functional inquiry into all systems) and an exam of all body parts and systems (GP21). 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

If you did a consultation, general assessment or general re-assessment of the patient before admission, payment is reduced to a lesser fee; bill Type 2 (W254) instead (GP49).
Use Type 3 (W257) for a re-admission after a stay of at least 3 days in another institution (GP49).
General assessments are limited to one per patient per physician per 12 months, or two if the diagnosis is clearly different or at least 90 days have passed and the second is a hospital admission assessment (GP21).
Not on the virtual care list, so not payable by video or phone (Appendix J).

Related codes: W254, W257, W259, W155, W153

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103; rules GP21, GP49.

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