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Billing code

W260A — Special paediatric consultation – long-term care

Long paediatric consult, LTC

Bill for a paediatric consultation in long-term care with at least 75 minutes of direct patient contact.

Watch for: Record start and stop times in the patient's record, or the service isn't eligible for payment.

Code

W260A

Description

Special paediatric 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

Paediatric consultation in long-term care with at least 75 minutes of direct patient contact. Same conditions as A260.

What it covers

A special paediatric consultation includes all the elements of a consultation (A265) plus at least 75 minutes in direct contact with the patient, not counting time on other separately billable services (A168).

W260 is the long-term care version and is subject to the same conditions as A260 (A174).

Billing rules

• Minimum 75 minutes of direct contact with the patient (A168).
• Time counts only direct contact with the patient, not other separately billable services or non-patient-facing work such as chart or imaging review (A168, A169).
• Record start and stop times in the patient's permanent record, or the service is not eligible for payment (A168).
• Needs a written, signed request from the referring physician or nurse practitioner naming the patient, the referrer's billing number and the reason; otherwise it is paid as a lesser assessment (GP16).
• Same patient, same physician, same diagnosis: one consultation per two consecutive 12-month periods, with a second allowed only for an in-patient or ED consult 12–24 months after the first; a clearly unrelated diagnosis allows one per 12 months. Extra consults are paid as an assessment (GP17, GP18).
• Non-emergency long-term care in-patient service: chronic care and convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent beds, but not designated palliative care beds. Emergency calls and special visits use the General Listings (A prefix) with premiums (A174, GP49).
• Specialist consultations, limited consultations and repeat consultations get an age premium: +30% under 30 days, +25% to 1 year, +20% to 2 years, +15% to 5 years, +10% to 16 years (GP64).

Often billed with

• K001 detention, only after 120 minutes of special paediatric consultation time (GP31).

Common rejections

• ARF: The referring provider number is missing. A consultation needs a written request that names the referring physician or nurse practitioner and their billing number (GP16).

Related codes: A260, C260, W265, W662, W667

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Paediatrics (26), page A174.

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