W001 – Additional subsequent visits
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A minor assessment rendered to a patient in a long-term care institution (chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, etc.). According to the definition of a minor assessment in the Schedule of Benefits (), this service includes a brief history and examination of the affected part or region or related to a mental or emotional disorder, or brief advice or information regarding health maintenance, diagnosis, treatment, and/or prognosis. 'W' prefix codes are used for non-emergency in-patient services ().
When to Use
- Use W001 for routine, non-urgent follow-up assessments of chronic conditions in a long-term care facility when the patient does not require the comprehensive monthly management provided under W010.
- Use this code for brief, non-emergency check-ins regarding stable mental health or emotional disorders in an institutional setting.
- Use W001 for providing brief advice or health maintenance counseling to a patient in a nursing home that does not meet the complexity threshold of an acute intercurrent illness visit (W121).
Common Pitfalls
- Billing W001 in the same calendar month as W010 is a common rejection, as subsequent visits are considered included in the monthly management fee.
- Attempting to bill W001 alongside special visit premiums will result in rejection; you must use an 'A' prefix code from the General Listings for any visit requiring a premium.
- Confusing W001 with W121; W001 is for minor, routine assessments, whereas W121 is specifically for acute intercurrent illnesses that do not qualify for special visit premiums.
Billing Tips
- If you are already in the facility and are called to assess a patient on an emergency basis, use an 'A' prefix code instead of W001 to ensure proper reimbursement for the emergency nature of the service.
- Ensure your documentation clearly distinguishes the 'minor' nature of the assessment to justify the use of W001 over the more comprehensive W121 or 'A' prefix codes.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary. ()
Keeping and maintaining appropriate medical records is a common element of all insured services. ()
The 'W' prefix codes are for non-emergency in-patient services in facilities such as chronic care hospitals, convalescent hospitals, nursing homes, and homes for the aged. (, )
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.