W993 – Additional person(s) seen - Weekdays Evenings
OHIP Neurology Code — GENERAL PREAMBLE · Schedule of Benefits
W993 is a special visit premium for each additional patient seen at a Long-Term Care Institution after the first patient. This premium is applicable when a physician is called for a non-elective service during weekdays evenings (Monday to Friday, 17:00-24:00). This premium is claimed in addition to an appropriate A-prefix assessment code. The time of the visit must be documented in the medical record.
When to Use
- Use W993 for the second and every subsequent patient seen during a non-elective, unscheduled visit to a Long-Term Care (LTC) facility between 17:00 and 24:00 on weekdays.
- Apply W993 in conjunction with W992, which must be claimed for the first patient seen during the same non-elective trip to the LTC facility.
Common Pitfalls
- Claiming W993 for routine, scheduled rounds at an LTC facility, which is strictly prohibited as these are considered elective services.
- Failing to document the exact time of the visit, which is a mandatory requirement for all special visit premiums and a frequent cause of audit recovery.
- Attempting to claim W993 for patients seen during a visit that was already scheduled, even if the visit occurs during the evening hours.
Billing Tips
- Always pair W993 with the appropriate A-prefix assessment code (e.g., A007) to ensure the claim is processed correctly under the General Listings.
- Ensure the non-elective nature of the call is clearly supported by the clinical record to justify the departure from standard elective rounding practices.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table IV - Long-Term Care Institution)
The time at which the special visit takes place must be documented on the medical record.
Commentary: Special visit premiums are not eligible for payment for elective services rendered at a long-term care institution, including a nursing home or home for the aged, even when the long-term care institution is the "home" of the patient. Submit claims for routine elective visits in these locations as subsequent visits. For example, if the physician is called to a nursing home to see a patient for a non-elective problem at 8AM, and subsequently sees his/her routine patients on rounds, those additional patients do not qualify for the additional person premium.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.