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A226 – Repeat consultation

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

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Levels of this visit

The A22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A221 Genetic minor assessment

    A minor assessment provided by a geneticist or a specialist with FCCMG designation, involving a brief history and examination or brief advice/information regarding health…

    $38.05

Consultations

  • A226 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…

    $119.40

  • A225 Consultation

    A consultation rendered by a specialist in Genetics (22) or a specialist with FCCMG designation, following a written request from a referring physician, nurse practitioner, or…

    $190.50

  • A220 Special genetic consultation

    Special genetic consultation is a consultation in which the physician provides all the elements of a consultation (A225) and spends a minimum of 75 minutes in direct contact with…

    $342.25

  • A223 Extended special genetic consultation

    Extended special genetic consultation is a consultation in which the physician provides all the elements of a consultation (A225) and spends a minimum of 90 minutes in direct…

    $442.40
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 new 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 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.
Usage limits
Not subject to the one-per-24-month limit applicable to initial consultations (A225), provided the definition of a repeat consultation is met.
A225Genetic consultationA220Special genetic consultation (minimum 75 minutes)A223Extended special genetic consultation (minimum 90 minutes)A325Limited genetic consultationA221Genetic minor assessment

If the requirements for a consultation (e.g., written request or report) are not met, the fee will be adjusted to a lesser assessment fee.

A repeat consultation cannot be billed if the consultant has been providing ongoing management; it requires care by another physician in the interval.

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