All codes
W312
W312 – First 4 subsequent visits per patient per month in chronic care or convalescent hospital
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment following a patient's admission to a chronic care or convalescent hospital. This service constitutes one of the first four subsequent visits to a patient in a given month. For a comprehensive definition of subsequent visits in this context, refer to .
When to Use
- Use W312 for the first four routine follow-up assessments performed on a patient admitted to a chronic care or convalescent facility within a single calendar month.
- Use W312 when the patient is stable and requires standard monitoring, as opposed to W121 which is reserved for acute intercurrent illnesses requiring additional intervention.
Common Pitfalls
- Billing W312 in the same month as W010 will trigger an automatic rejection because W010 includes routine management visits.
- Exceeding the four-visit monthly limit for W312 without switching to W311 for the fifth and sixth visits will result in claim denials.
- Failing to differentiate between routine chronic care visits and acute intercurrent illness visits (W121) leads to lost revenue, as W121 is payable regardless of the W312/W311 monthly caps.
Billing Tips
- Track your monthly visit count per patient carefully; once you hit the 4th W312, ensure all subsequent routine visits for that month are billed as W311 to avoid rejection.
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
For general rules regarding subsequent visits in long-term care institutions, see .
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