What is OHIP billing code A096?

A096 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A096 pay?

The current OHIP fee for A096 is $75.20, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A096 to OHIP?

A096 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A096 claims against the Schedule of Benefits rules before submission.

What codes are related to A096?

Codes related to A096 in the Schedule of Benefits include A095, C096, W096, A935.

All codes

A096

A096 – Repeat consultation

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

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Levels of this visit

The A09x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A094 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…
$30.35
A093 Specific assessment
A service rendered by a specialist in Cardiac Surgery (09) in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination…
$55.70

Consultations

A096 Repeat consultation(this code)
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…
$75.20
A095 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).
$113.15

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

Written request from a referring physician, nurse practitioner, or dental surgeon

New written request required specifically for the repeat consultation

Written report including findings, opinions, and recommendations must be sent to the referrer

Must follow care rendered by another physician in the interval since the initial 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.

Usage limits

Not subject to the 'one per 24 months' limit applicable to regular consultations.

A095Consultation C096Repeat consultation (Hospital In-patient)W096Repeat consultation (Long-term care)A935Special surgical consultation

If requirements are not met, the fee is adjusted to a lesser assessment fee.

Physician in hospital but not on duty in the emergency department should use this General Listing (A096).

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