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A046 – Repeat consultation

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The A04x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A044 Partial assessment

    A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate…

    $33.40

  • A043 Specific assessment

    A specific assessment is a service rendered by a specialist in Neurosurgery (04) in a place other than a patient’s home.

    $64.90

Consultations

  • A046 Repeat consultation(this code)

    A 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…

    $64.85

  • A045 Consultation

    A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).

    $145.60
A 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.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
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 consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.
Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
Usage limits
Repeat consultations are an exception to the general limit of one consultation per two consecutive 12-month periods for the same diagnosis by the same physician.
A045ConsultationA935Special surgical consultationA043Specific assessmentA044Partial assessment

A repeat consultation is specifically for cases where another physician has provided care for the same problem in the interval between the initial and repeat consultation.

For emergency calls or special visits in LTC settings, refer to Special Visit Premiums ( to ).

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