(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.
