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Geriatric Medicine OHIP billing codes
Geriatric consultations including comprehensive and extended forms, in-patient and long-term care visits, home visits, cognitive assessment and case conferences.
45 codes in 6 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 07 is in the full Geriatrics listing.
Consultations & assessments — office
- A075Geriatric consultation—
- A775Comprehensive geriatric consultation—
- A770Extended comprehensive geriatric consultationExtended comprehensive geriatric consultation (minimum 90 minutes)—
- A375Limited ConsultationLimited Consultation - Geriatrics (07)—
- A076Repeat consultationA repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval following the initial consultation but preceding the repeat consultation. A repeat consultation has the same requirements as a consultation including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon.—
- A073Medical specific assessmentMedical specific assessment - Geriatrics—
- A074Medical specific re-assessmentMedical specific re-assessment (Geriatrics)—
- A071Complex medical specific re-assessment—
- A078Partial assessmentPartial assessment (Geriatrics)—
- A070Geriatric consultationConsultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patient.—
Hospital in-patient
- C075Geriatric Consultation - Non-Emergency Hospital In-Patient—
- C775Comprehensive geriatric consultationA comprehensive consultation for a hospital in-patient by a geriatric specialist, subject to the same conditions as <billingCode>A775</billingCode>.—
- C770Extended comprehensive geriatric consultationAn extended comprehensive geriatric consultation for a non-emergency hospital in-patient, provided by a specialist in Geriatrics (07). This service requires a written request and is subject to the same conditions as the general listing <billingCode>A770</billingCode>, which include being for a patient at least 65 years of age or for the assessment of dementia, and involves a minimum of 90 minutes in direct contact with the patient.—
- C375Limited consultationA limited consultation provided by a Geriatrics (07) specialist for a non-emergency hospital in-patient. This service is less demanding and time-consuming than a full consultation but must meet all other requirements for a consultation.—
- C076Repeat consultation—
- C072Subsequent visit - first five weeks—
- C073Subsequent visit - first 2 per monthMedical specific assessment - Geriatrics (Hospital In-patient)—
- C077Subsequent visit - sixth to thirteenth week inclusive—
- C079Geriatric subsequent visit - after thirteenth weekSubsequent visit for a non-emergency hospital in-patient provided by a Geriatrics specialist, rendered after the thirteenth week of admission. Subject to a maximum of six visits per month.—
- C078Subsequent visits per monthSubsequent visits per month (LTC) / Concurrent care (Hospital)—
- C074Medical specific re-assessmentA medical specific re-assessment for a non-emergency hospital in-patient, rendered by a specialist in Geriatrics (07). This service requires a full, relevant history and physical examination of one or more systems.—
- C071Complex medical specific re-assessmentComplex medical specific re-assessment (Geriatrics)—
Long-term care
- W075Consultation - Non-Emergency Long-Term Care In-Patient ServicesA consultation rendered by a Geriatrics specialist for a patient in a long-term care facility, including chronic care hospitals, convalescent hospitals, nursing homes, or homes for the aged. This service follows the general rules for consultations, requiring a written request and a report back to the referring practitioner.—
- W775Comprehensive geriatric consultationA comprehensive geriatric consultation for a patient in a non-emergency long-term care setting, such as a nursing home or chronic care hospital. This service is subject to the same conditions as general listing consultation <billingCode>A775</billingCode>.—
- W770Extended comprehensive geriatric consultationAn extended comprehensive geriatric consultation for a non-emergency in-patient in a long-term care facility. This service is subject to the same conditions as <billingCode>A770</billingCode>.—
- W375Limited consultationA limited consultation provided by a Geriatrics specialist for a patient in a long-term care institution. This service is less demanding than a full consultation and requires a written request from a referring practitioner.—
- W076Repeat ConsultationA repeat consultation for the same problem for a patient in a long-term care setting, requested by another physician, nurse practitioner, or dental surgeon. This service requires a new written referral and a report back to the referring practitioner.—
- W078Subsequent Visit - Nursing Home or Home for the AgedA routine subsequent assessment for a patient in a nursing home or home for the aged. This service is limited to a maximum of three per patient, per physician, per month, following the first two subsequent visits.—
- W073First 2 subsequent visits per patient per month - Nursing home or home for the agedA routine subsequent visit for a patient in a nursing home or home for the aged. Limited to the first 2 visits per patient, per physician, per month, provided by a Geriatrician (07).—
- W074General reassessment of patient in nursing homeA general reassessment for a patient in a nursing home as specified by the Nursing Homes Act. This service may only be claimed 6 months after a Periodic health visit.—
- W272Admission assessment - Type 1A Type 1 admission assessment is a general assessment rendered to a patient on admission to a long-term care facility. The fee may be adjusted if a prior assessment for the same illness was performed.—
- W274Admission assessment - Type 2A Type 2 admission assessment is an initial visit by the admitting physician to assess a patient's condition in a long-term care institution, where the physician has already performed a prior consultation, general assessment, or general re-assessment for the patient before admission.—
- W277Admission assessment - Type 3A general re-assessment of a patient who is re-admitted to the long-term care institution after a minimum 3 day stay in another institution.—
- W107Type 3 admission assessmentA Type 3 admission assessment is a general re-assessment of a patient who is re-admitted to the long-term care institution after a minimum 3 day stay in another institution.$30.70
- W279Periodic health visitA periodic health visit for a patient in a non-emergency long-term care setting, focusing on age and gender-appropriate history, examination, screening, and counselling. This service is limited to one per patient, per physician, per 12-month period.—
Home visits
- B988First person seen - Geriatric Home Visit - Any day 07:00-24:00 (weekdays, evenings, Sat., Sun. and Holidays)A premium for the first person seen during a non-elective special visit to a patient's home for a geriatric home visit, for visits that commence on any day between 07:00 and 24:00 (nights have their own code).$91.80
- B987First person seen - Geriatric Home Visit - Nights (00:00-07:00)A premium for the first person seen during a non-elective special visit to a patient's home for a geriatric home visit, for visits that commence between 00:00 and 07:00 on any day.$113.10
- B986Travel Premium - Geriatric Home Visit - Any timeA travel premium for a non-elective special visit to a patient's home for a geriatric home visit, for visits that commence at any time.$37.40
Cognition, phone support & case conferences
- K042Extended specific neurocognitive assessmentAn extended assessment of neurocognitive function, requiring a minimum of 46 minutes, rendered personally by a physician from a specific specialty. It involves testing memory, attention, language, visuospatial function, and executive function.—
- K077Geriatric telephone supportThis is the service initiated by a caregiver where a physician provides telephone support to a caregiver(s) for a patient with an established diagnosis of dementia.$43.10
- K703Geriatric out-patient case conferenceA time-based case conference for an out-patient who is either 65 years or older, or has dementia. This service requires participation from the most responsible physician and at least two other healthcare professionals, and is only billable by specific physicians.$37.05
How to use this geriatrics code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to geriatrics (specialty 07) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a geriatrics physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does geriatric medicine bill?
The consultations & assessments — office section of this set starts with A075 (Geriatric consultation). 10 codes are listed in that section.
What is in the Geriatric Medicine code set?
45 OHIP billing codes across 6 sections: Consultations & assessments — office; Hospital in-patient; Long-term care; Home visits; Cognition, phone support & case conferences; Premiums. Geriatric consultations including comprehensive and extended forms, in-patient and long-term care visits, home visits, cognitive assessment and case conferences.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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