W720 – Comprehensive occupational medicine or Comprehensive internal medicine consultation (Long-Term Care)
OHIP Neurology Code · Schedule of Benefits
This service is a consultation rendered by a specialist in occupational medicine or internal medicine who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of direct contact with the patient exclusive of time spent rendering any other separately billable intervention to the patient. (Derived from A152, A151, A128)
When to Use
- Use W720 for complex internal medicine consultations in a long-term care facility where the patient requires a comprehensive assessment exceeding 75 minutes of direct face-to-face time.
- Use this code when performing a detailed diagnostic workup for a new, unrelated condition in a patient already managed under a W010 monthly management fee by a different physician.
Common Pitfalls
- Billing W720 when the 75-minute threshold includes chart review or documentation time, which are explicitly excluded from the direct patient contact requirement.
- Submitting W720 on the same day as other assessment services, which will trigger an automatic rejection or adjustment to a lower-paying code like W725 or W925.
- Failing to document precise start and stop times in the medical record, which is the primary audit trigger for this high-value consultation code.
Billing Tips
- Ensure the referral is clearly documented in the LTC common medical record, including the referring provider's name and billing number, to satisfy the mandatory referral requirement.
- If the 75-minute direct contact threshold is not met, proactively bill W725 or W925 to avoid the administrative burden of claim adjustments.
Effective: April 1, 2026
Non-Emergency Long-Term Care In-Patient Services
Consultation
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
The physician must spend a minimum of 75 minutes in direct contact with the patient.
The start and stop times must be recorded in the patient’s permanent medical record.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.