Billing code
W259A — Endocrinology periodic health visit – long-term care
LTC health visit, endocrinology
Bill for an endocrinologist's periodic health visit for a resident of a long-term care institution.
Watch for: The nursing home re-assessment W154 can only be claimed 6 months after this visit; not payable by video or phone.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $65.05 | $0.00 | $0.00 | $0.00 |
- Code
- W259A
- Description
- Endocrinology periodic health visit – long-term care
- 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
Periodic health visit by an endocrinologist for a resident of a long-term care institution.
What it covers
W259 is the periodic health visit listed under Endocrinology for long-term care patients (A103). 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).
The general re-assessment of a nursing home patient under the Nursing Homes Act (W154) may only be claimed 6 months after the periodic health visit (A103).
Billing rules
- W154 may only be claimed 6 months after this periodic health visit (A103).
- Not on the virtual care list, so not payable by video or phone (Appendix J).
Related codes: W154, W252, W257, W153
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Endocrinology & Metabolism (15), page A103.
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