W022 – Subsequent visits - chronic care or convalescent hospital - first 4 per month
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Represents the first four subsequent visits per patient per month in a chronic care or convalescent hospital. A subsequent visit is a routine assessment following the patient's admission to a long-term care institution. For rules regarding non-emergency in-patient services in long-term care institutions, see .
When to Use
- Use W022 for routine, non-acute follow-up assessments of patients admitted to a chronic care or convalescent facility, limited to the first four visits per month.
- Apply this code when performing standard monitoring of a patient's chronic condition where no acute intercurrent illness is present.
Common Pitfalls
- Billing W022 concurrently with W010 is a common audit trigger, as W022 is considered a component of the monthly management fee and is not separately payable.
- Attempting to use W022 for acute intercurrent illnesses will result in rejection; these must be billed using W121 or appropriate 'A' prefix codes if special visit premiums apply.
Billing Tips
- If you are already in the facility and are requested to assess another physician's patient for an emergency, use 'A' prefix codes instead of W022 to ensure proper compensation for the emergency service.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
All insured services must be documented in appropriate records to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary. See .
See General Preamble .
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.