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W028
W028 – Additional subsequent visits (maximum 3 per patient per month) - Nursing home or home for the aged - Dermatology
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
This service is for an additional subsequent visit to a patient in a nursing home or home for the aged. It is payable for visits after the initial two subsequent visits of the month (claimed under W023). Subsequent visits are routine assessments following a patient's admission to a long-term care institution, as defined in the General Preamble on page .
When to Use
- Use W028 for the third, fourth, and fifth subsequent dermatology visits to a nursing home patient within a single calendar month after the two W023 claims have been exhausted.
- Apply this code when providing medically necessary dermatological follow-up assessments in a long-term care facility that exceed the routine frequency covered by W023.
Common Pitfalls
- Billing W028 in the same month as W010 will trigger an automatic rejection, as subsequent visits are considered included in the monthly management fee.
- Exceeding the maximum of 3 claims per patient per month for W028 will result in the additional claims being rejected or flagged for manual audit.
Billing Tips
- Ensure your billing software tracks the count of W023 claims per patient per month to trigger the switch to W028 automatically once the threshold is met.
- Document the specific dermatological indication requiring these additional visits to justify the necessity of exceeding the standard W023 visit frequency during an audit.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Assessment
Code Classes
Hospital and Institutional Consultations and Assessments
See General Preamble for rules on subsequent visits in long-term care institutions.
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