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W031 – Chronic care or convalescent hospital - additional subsequent visits

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A subsequent visit is a routine assessment following a patient's admission to a long-term care institution (see ). This specific service, W031, applies to additional subsequent visits for a patient in a chronic care or convalescent hospital. It is payable for visits rendered after the first four subsequent visits (see W032) in a calendar month, up to a maximum of six W031 visits per month. As per , an assessment includes a direct physical encounter with the patient, history taking, physical examination, and arranging for any related care.
The medical record must 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.

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