What is OHIP billing code A266?

A266 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A266 pay?

The current OHIP fee for A266 is $104.70, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A266 to OHIP?

A266 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A266 claims against the Schedule of Benefits rules before submission.

What codes are related to A266?

Codes related to A266 in the Schedule of Benefits include A265, A565, A665.

All codes

A266

A266 – Repeat consultation

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

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Levels of this visit

The A26x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A261 Level 1 - Paediatric assessment
A Level 1 paediatric assessment includes one or both of the following: a brief history and examination of the affected part or region or related to a mental or emotional disorder…
$24.85
A262 Level 2 - Paediatric assessment
A Level 2 paediatric assessment is a paediatric service that requires a more extensive examination than a level 1 paediatric assessment.
$50.20
A264 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist in Paediatrics (26) that requires a full, relevant history and physical examination of one or more systems.
$70.75
A263 Medical specific assessment
A service rendered by a specialist in Paediatrics requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s)…
$95.75

Consultations

A266 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…
$104.70
A265 Consultation
A consultation rendered by a Paediatrician following a written request from a referring physician, nurse practitioner, or dental surgeon, requiring a comprehensive assessment and…
$190.35
A260 Special paediatric consultation
A special paediatric consultation is a consultation in which the physician provides all the elements of a consultation (A265) 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.

The consultant must prepare 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.

The request must identify the consultant, the referring provider, and the patient by name and billing/health numbers.

A copy of the written request must be kept in the consultant's medical record.

Usage limits

A266 is an exception to the general limit of one consultation per two consecutive 12-month periods for the same diagnosis by the same physician.

A265Consultation (Paediatrics)A565Limited consultation (Paediatrics)A665Prenatal consultation

A repeat consultation is used when the same consultant is asked to see the patient again for the same problem, but only if another physician has provided care for that problem in the interim.

If the requirements for a repeat consultation are not met, the service may be adjusted to a lesser assessment fee.

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