1What Is the A900 OHIP Code?
The A900 billing code is designed for family physicians conducting complex house call assessments. It is explicitly targeted at frail elderly or housebound patients who cannot easily access medical services in a typical office setting. This code acknowledges the additional complexity and time involved in assessing patients with multiple conditions, cognitive impairments, or reduced mobility.
In clinical practice, A900 is commonly missed due to misunderstanding eligibility criteria or failing to document the necessary details. It's essential that the assessment is appropriately recorded, detailing the patient’s frailty or the circumstances rendering them housebound.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Not specified | $247.40 - Consultation focused on comprehensive care through video. |
| A006 | Repeat consultation | Not specified | $47.10 - Follow-up consultations requiring further patient assessment. |
| A010 | GP focused practice consultation by Video | Not specified | $95.60 - Initial GP consultations provided via video for focused care. |
| A011 | GP focused practice repeat consultation by Video | Not specified | $47.10 - Follow-up GP consultations offered via video. |
3Eligibility Requirements
To be eligible for the A900 code:
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Patient Type: The patient must be either a frail elderly individual (aged 65+ with complex medical needs, cognitive impairment, reduced mobility, or unexplained functional decline) or a housebound patient (not able to access office-based care, with transportation considered ineffective or inappropriate).
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Location: Services must be rendered in the patient's home or an assisted living or retirement residence, but not in a long-term care facility.
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Frequency: A900 is eligible only for the first patient seen during a single house call visit to a location.
4What Your Clinical Note Must Show
Ensure all documentation standards are met for A900 claims to be payable.
- Provide details that demonstrate an intermediate assessment was conducted.
- Document that the patient qualifies as either frail elderly or housebound.
5Weak vs. Strong Note Examples
The strong note clearly articulates the patient's medical complexities and eligibility criteria, whereas the weak note lacks detail and fails to establish the patient's qualification for the A900 code.
Patient was seen at home. Assessment conducted. Patient is elderly.
Patient seen at home due to frail status, aged 72, recently diagnosed with dementia. Complex management needed for hypertension and diabetes. Patient has fallen twice in the last month, indicating reduced mobility.
- Detailed medical history and cognitive assessment documented.
- Assessment confirms reduced mobility and need for polypharmacy.
