A900 – Complex house call assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A primary care service rendered in a patient's home to a patient that is considered either a frail elderly patient or a housebound patient. The service provided must satisfy, at a minimum, all of the requirements of an intermediate assessment.
When to Use
- Bill A900 for a patient 70+ with dementia and polypharmacy who requires a comprehensive assessment of their complex medical needs at home, as they are unable to attend the office.
- Use A900 for a patient with severe mobility issues and a history of falls, who meets the 'housebound' criteria and requires an intermediate assessment in their residence.
- A900 is appropriate for a patient recently discharged from hospital with multiple comorbidities, requiring an in-home assessment to manage their complex care needs and prevent readmission.
Common Pitfalls
- Billing A900 for a patient who does not meet the strict definition of 'frail elderly' or 'housebound', leading to audits.
- Submitting A900 for a patient who could reasonably attend an office visit (e.g., a younger patient with a minor, easily managed condition).
- Failing to document that the service met all requirements of an intermediate assessment (as per A007) in addition to the frail elderly/housebound criteria.
Billing Tips
- A900 is not eligible for the 15% age premium (E075), unlike some other assessment codes for patients 65+.
- Remember that A900 is only payable for the first patient seen at a single location during a visit, even in multi-resident dwellings like retirement homes.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Family Practice & Practice in General
Assessment
The service must satisfy all requirements of an intermediate assessment.
The patient must meet the definition of 'frail elderly' or 'housebound'.
For the purposes of A900, a frail elderly patient is a patient who is 65 years of age or over who has one or more of the following: Complex medical management needs, that may include polypharmacy; Cognitive impairment (e.g. dementia or delirium); Age-related reduced mobility or falls; or Unexplained functional decline not otherwise specified.
For the purposes of A900, a housebound patient is a patient who meets all the following criteria: The person has difficulty in accessing office-based primary health care services because of medical, physical, cognitive, or psychosocial needs/conditions; Transportation and other strategies to remedy the access difficulties have been considered but are not available or not appropriate in the person's circumstances; and The person's care and support requirements can be effectively and appropriately delivered at home.
Medical record must demonstrate that an intermediate assessment was rendered and that the patient was a frail elderly or housebound patient.
The service applies to a frail elderly patient (age 65+); or or a housebound patient (no age restriction)
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