W299 – Subsequent visit, in hospital, by the same physician, for the same condition
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A periodic health visit (including a primary or secondary school examination) is performed on a patient, after their second birthday, who presents and reveals no apparent acute physical or mental illness. The service must include an intermediate assessment, a level 2 paediatric assessment or a partial assessment focusing on age and gender appropriate history, physical examination, health screening and relevant counselling. This service is for patients in chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged, and designated chronic or convalescent care beds in hospitals, other than patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable (see to ).
When to Use
- Use for routine, non-acute periodic health assessments of patients aged 2 or older residing in chronic care, convalescent, or long-term care facilities.
- Use when performing a scheduled, age-appropriate health screening or physical examination for a patient in a nursing home or home for the aged who has no active acute illness.
Common Pitfalls
- Do not use W299 for acute illness visits; if the patient presents with an acute issue, you must bill a standard hospital visit code (e.g., C002) instead.
- Claims will be rejected if you exceed the limit of one periodic health visit per patient, per physician, per 12-month period.
- Do not use W299 for patients in designated palliative care beds, as these are explicitly excluded from this code's scope.
Billing Tips
- Ensure your documentation explicitly confirms the absence of acute physical or mental illness to satisfy the specific clinical requirement for this code.
- When visiting a long-term care facility, remember that W299 is eligible for additional Special Visit Premiums (e.g., W990, W960) if the criteria for a 'special visit' are met.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments, Hospital and Institutional Consultations and Assessments
The service must include an intermediate assessment, a level 2 paediatric assessment or a partial assessment focusing on age and gender appropriate history, physical examination, health screening and relevant counselling.
All insured services must be documented in appropriate records that establish: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
Performed on a patient after their second birthday
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .
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