All codes
A444
A444 – General re-assessment of patient in nursing home
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Medical specific re-assessment rendered by a specialist in Medical Oncology.
When to Use
- Bill A444 for a Medical Oncology specialist performing a re-assessment of a patient in a nursing home, focusing on their cancer management and overall status.
- Use A444 when a Medical Oncology specialist needs to conduct a comprehensive review of a nursing home resident's cancer treatment plan, including new symptoms or treatment adjustments, distinct from a routine periodic health visit.
- A444 is appropriate for a Medical Oncology specialist's re-assessment of a nursing home patient when the patient's condition requires a detailed history, physical exam, and specific medical advice related to their oncological care.
Common Pitfalls
- Billing A444 when the service is provided in a long-term care facility, as W444 is the correct code for nursing home visits by specialists.
- Claiming A444 more than twice per patient per physician in a 12-month period, which will result in the claim being adjusted to a lesser assessment fee.
- Billing A444 on the same day as another assessment or consultation code (e.g., A441, A443) by the same physician for the same patient, as these are not payable together.
Billing Tips
- Ensure the assessment includes a full, relevant history and physical examination of one or more systems, along with specific advice to the patient and an appropriate medical record, to meet the requirements for A444.
- Remember that the Chronic Disease Assessment Premium (E078) is not payable with A444 if the service is rendered in a long-term care facility, even though A444 is for a specialist's re-assessment.
Provider Fee$0.00
Specialist Fee$61.25
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
Requires a full, relevant history and physical examination of one or more systems.
Must include advice to the patient and an appropriate medical record.
The fee for A444 is $72.00 for specialists.
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