What is OHIP billing code A166?

A166 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A166 pay?

The current OHIP fee for A166 is $116.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A166 to OHIP?

A166 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A166 claims against the Schedule of Benefits rules before submission.

What codes are related to A166?

Codes related to A166 in the Schedule of Benefits include A165, A160, C166.

All codes

A166

A166 – Repeat consultation

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

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Levels of this visit

The A16x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A168 Partial assessment
A partial assessment is a limited medical service that includes a history of the patient's presenting complaint, the necessary physical examination, advice to the patient, and the…
$44.75
A164 Medical specific re-assessment
A medical specific re-assessment rendered by a specialist in Nephrology.
$72.00
A161 Complex medical specific re-assessment
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition and includes all the…
$83.40
A163 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in Nephrology (16) in a place other than a patient’s home.
$95.95

Consultations

A166 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…
$116.75
A165 Consultation
A consultation rendered by a specialist in nephrology following a written request from a referring physician, nurse practitioner, or dental surgeon.
$180.75
A160 Comprehensive nephrology consultation
A consultation rendered by a specialist in nephrology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes of direct…
$342.25

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 written request from a referring physician, nurse practitioner, or dental surgeon is required.

The consultant must provide a written report (including findings, opinions, and recommendations) to the referring provider.

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

A copy of the signed written request must be kept in the consultant's medical record (unless a common medical record is used in a hospital or multi-specialty clinic).

The request must identify the consultant, the referrer (including billing number), and the patient (including health number).

The service must follow care rendered to the patient by another physician in the interval since the initial consultation.

Usage limits

Repeat consultations (A166) are not subject to the general limit of one consultation per two consecutive 12-month periods for the same diagnosis.

A165Nephrology consultation A160Comprehensive nephrology consultation C166Nephrology repeat consultation (In-patient)

A repeat consultation has the same requirements as a full consultation, including the need for a new written request.

If the requirements for a consultation are not met (e.g., no written request or report), the fee will be reduced to a lesser assessment fee.

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