What is OHIP billing code A086?

A086 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A086 pay?

The current OHIP fee for A086 is $62.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A086 to OHIP?

A086 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A086 claims against the Schedule of Benefits rules before submission.

What codes are related to A086?

Codes related to A086 in the Schedule of Benefits include A085, A935, A083, A084.

All codes

A086

A086 – Repeat consultation

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

Ask a question

Levels of this visit

The A08x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A084 Partial assessment
A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate…
$34.75
A083 Specific assessment
A specific assessment is a service rendered by a specialist in a place other than a patient's home.
$54.40

Consultations

A086 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…
$62.80
A085 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for insured dental procedures in hospital).
$106.25

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.

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.

The consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.

A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner or dental surgeon.

Usage limits

Not subject to the standard limit of one consultation per two consecutive 12-month periods, provided the criteria for a 'repeat' consultation are met ().

A085Consultation A935Special surgical consultation A083Specific assessment A084Partial assessment

If the requirements for a repeat consultation are not met (e.g., no new written request or no interval care by another physician), the fee will be adjusted to a lesser assessment fee.

Eligible for age-based fee premiums for patients under 16 years of age (10% to 30% increase depending on age).

Eligible for Special Visit Premiums ( to ) when applicable for emergency or special calls.

Ready to bill this code?

SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.

Get Started Free Already have an account? Sign in