What is OHIP billing code W164?

W164 is "General re-assessment of patient in nursing home", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W164 pay?

The current OHIP fee for W164 is $20.60, effective 2025-06-01, per the Ontario Schedule of Benefits.

How do I bill W164 to OHIP?

W164 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W164 claims against the Schedule of Benefits rules before submission.

What codes are related to W164?

Codes related to W164 in the Schedule of Benefits include W004, A004, C004, W165, W765, W160, W865, W166.

All codes

W164

W164 – General re-assessment of patient in nursing home

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

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Levels of this visit

The W16x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

W164 General re-assessment of patient in nursing home(this code)
A general re-assessment of a patient in a non-emergency long-term care setting, such as a nursing home, as per the requirements of the Nursing Homes Act.
$20.60

Consultations

W166 Repeat consultation
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another…
$116.75
W165 Consultation
A consultation provided by a Nephrology (16) specialist to a patient in a non-emergency, long-term care setting.
$180.75
W160 Comprehensive nephrology consultation
A comprehensive nephrology consultation for a patient in a non-emergency long-term care in-patient service setting.
$342.25

A general re-assessment of a patient in a non-emergency long-term care setting, such as a nursing home, as per the requirements of the Nursing Homes Act. According to , a general re-assessment includes all the services listed for a general assessment, with the exception of the patient's history, which need not include all the details already obtained in the original assessment. As a 'W' prefix code, this service applies to patients in chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent care beds in hospitals (as per ). It is intended for routine assessments and not for emergency calls or special visits, for which 'A' prefix codes and special visit premiums should be used.

W004 A004 C004 W165 W765 W160 W865 W166 W862 W864 W867 W869

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