A General Assessment cannot be claimed

(a) only one is payable per nursing home resident per year, 

(b) no other home visit or premium is payable in addition for the same visit to the same resident, 

(c) where applicable, the first patient seen may be claimed as an elective home visit (visit code 246 or 286), rather than as a General Assessment, and

(d) extra residents seen in addition to the first patient and residents who required admission or annual General Assessments should be claimed using code 252 or code 292.

 A General Assessment cannot be claimed: 

(a) by physicians when they are providing dedicated on-site Emergency Department coverage at designated hospital facilities listed in Appendix A. 

(b) solely because a patient presents for assessment 90 or more days after a general assessment was previously performed. 

(c) for screening of patients with chronic disease(s) who do not have acute signs or symptoms involving all the body systems.

Not more than one major examination (Consultation, General Assessment, or Specific Assessment) per patient per physician may be claimed within a 90-day period regardless of diagnosis and referral source, except in case of true emergency. Such claims must be submitted IC clarifying the nature of the emergency.

General Reassessment 

A General Reassessment shall consist of the same services, terms and conditions and record keeping as a General Assessment except that the service is rendered within 90 days of the previous General Assessment or Consultation. 

Not more than one General Reassessment per patient per physician may be billed within a 60-day period, regardless of diagnosis and referral source.

 Geriatric Surcharge for Internists 

Specialists and sub-specialists in Internal Medicine may claim a fee in addition to applicable consultation, assessment, reassessment, detention, critical care, and escort codes for patients 65 years of age and older (codes 190, 290, 390, or 490). These codes cannot be billed in addition to codes for SHVs, diagnostic and therapeutic procedures, in-hospital diagnostic procedures, and surgical procedures.