What is OHIP billing code A196?

A196 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A196 pay?

The current OHIP fee for A196 is $120.30, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A196 to OHIP?

A196 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A196 claims against the Schedule of Benefits rules before submission.

What codes are related to A196?

Codes related to A196 in the Schedule of Benefits include C196, A196A, A190, A195.

All codes

A196

A196 – Repeat consultation

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

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Levels of this visit

The A19x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A194 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…
$47.05
A193 Specific assessment
A specific assessment is a service rendered by a specialist in Psychiatry, in a place other than a patient’s home, requiring a full history of the presenting complaint and a…
$98.70

Consultations

A196 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…
$120.30
A195 Psychiatric consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental…
$254.30
A190 Special psychiatric consultation
Special psychiatric consultation is a consultation in which the physician provides all the elements of a consultation (A195) and spends a minimum of 75 minutes in direct contact…
$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

Requires a new written request from a referring physician, nurse practitioner, or dental surgeon (in connection with an insured dental procedure in a hospital).

The consultant must 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 prepared and sent to the referring provider.

A copy of the signed written request must be kept in the consultant'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 service per two consecutive 12 month periods' limit that applies to initial consultations (/18).

C196Repeat psychiatric consultation (Hospital Inpatient)A196ARepeat psychiatric consultation (Video Only)A190Psychiatric consultation A195Special psychiatric consultation

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 adjusted to a lesser assessment fee.

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