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A206

A206Repeat consultation

OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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.

When to Use

  • Bill A206 when a patient sees a specialist for a specific problem, then sees their GP for management, and then returns to the specialist for a follow-up on the same problem, provided the GP's assessment is documented.
  • Use A206 if a patient is referred to a specialist, sees another physician (e.g., a different specialist or GP) for an interim assessment related to the original referral, and then returns to the original specialist for a repeat consultation on that same issue.
  • A206 is appropriate when a consultant provides an initial consultation (e.g., A203), the patient is subsequently managed by another physician for the same presenting problem, and the consultant then sees the patient again for a repeat consultation.

Common Pitfalls

  • Claiming A206 when the patient has not been seen by another physician in the interval; this scenario would typically be billed as a standard consultation (A203/A204) or a follow-up visit (e.g., A007).
  • Failing to obtain and retain a written request from the referring provider, which is a mandatory requirement for A206 and can lead to claim rejection or audits.
  • Not sending a written report to the referring provider after the repeat consultation; this omission can result in the claim being denied or flagged for review.

Billing Tips

  • Ensure the written request for the repeat consultation clearly identifies the consultant, the referring provider (including their OHIP billing number), and the patient.
  • When billing A206, confirm that the patient's presenting problem remains the same as the initial consultation; a new problem would necessitate a new consultation code.
Provider Fee$0.00
Specialist Fee$59.45

Effective: June 1, 2025

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Office/Outpatient

Code Classes

Consultation

Special visit premiums (Travel and Person Seen) may be claimed if the visit is non-elective and meets -78 criteria.

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