W181 – Additional subsequent visits (maximum of 6 per patient per month) - Chronic care or convalescent hospital
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
W181 is an additional subsequent visit for a patient under the care of a neurologist in a chronic care or convalescent hospital. Per , a subsequent visit is any routine assessment following the patient's admission to a long-term care institution. This code is payable for visits 5 through 10 per patient per month, with a maximum of six (6) services using this code per month. The first four (4) visits should be claimed using W182. Visits for acute intercurrent illness should be claimed using W121 and are not subject to these monthly limits. For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums.
When to Use
- Use W181 for the 5th through 10th routine neurological follow-up visits within a single calendar month in a chronic care or convalescent facility.
- Use this code for stable patients requiring ongoing neurological monitoring after the initial four visits have already been billed under W182.
Common Pitfalls
- Billing W181 before the four W182 visits are exhausted will result in automatic rejection by the Ministry.
- Attempting to use W181 for an acute intercurrent illness, which must be billed under W121 to avoid the monthly volume caps.
- Claiming W181 alongside special visit premiums is prohibited; use 'A' prefix codes if an emergency assessment is required.
Billing Tips
- Track your monthly visit count per patient carefully, as the Ministry strictly enforces the 10-visit limit (4 W182 + 6 W181) for routine chronic care.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
As with all assessments, a direct physical encounter with the patient is required, including taking a history and performing a physical examination. The service must be documented in the patient's medical record.
This service is for subsequent visits in a chronic care or convalescent hospital.
See for general rules on subsequent visits in long-term care institutions.
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