A006 – Repeat consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
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.
When to Use
- Bill A006 when a patient returns for follow-up on the same presenting problem after seeing another physician for interval care, and the initial consultation was more than 12 months ago.
- Use A006 if the patient was initially seen for a complex cardiac issue, saw their GP for management of a new viral illness, and now returns to the cardiologist for the original cardiac problem.
- A006 is appropriate if the patient was referred for management of rheumatoid arthritis, saw their GP for a new onset of back pain, and now returns to the rheumatologist for their arthritis management.
Common Pitfalls
- Billing A006 when the patient has not seen another physician for the same problem in the interval since the initial consultation; this should be billed as a new consultation (A005) if within 12 months, or potentially not billable if the 12-month rule for A005 applies and no other criteria are met.
- Submitting A006 when the new referral is for a different, unrelated medical condition; this requires a new consultation code (A005) and is subject to the 12-month limit for A005.
- Failing to obtain and retain a new written request from the referring provider for the repeat consultation, unless the patient is in a common record environment like a hospital.
Billing Tips
- Ensure the report sent to the referring provider clearly outlines the findings, opinions, and recommendations related to the original presenting problem for which the repeat consultation was requested.
- Verify that the patient's record contains documentation of interval care by another physician for the same presenting problem prior to billing A006.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultation
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
A written report (including findings, opinions, and recommendations) must be sent to the referring provider.
The consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
A repeat consultation is specifically for the same presenting problem as the initial consultation.
If the consultant is referred for a clearly defined unrelated diagnosis, it is billed as a new consultation (subject to the 12-month limit) rather than a repeat consultation.
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