What is OHIP billing code A416?

A416 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does A416 pay?

The current OHIP fee for A416 is $106.90, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill A416 to OHIP?

A416 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates A416 claims against the Schedule of Benefits rules before submission.

What codes are related to A416?

Codes related to A416 in the Schedule of Benefits include A415, A545, A413, C416.

All codes

A416

A416 – Repeat consultation

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

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Levels of this visit

The A41x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

A418 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…
$44.75
A414 Medical specific re-assessment
A medical specific re-assessment is a service rendered by a specialist requiring a full, relevant history and physical examination of one or more systems.
$72.00
A411 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.
$83.40
A413 Medical specific assessment
A medical specific assessment is a service rendered by a specialist in a place other than a patient’s home.
$95.95

Consultations

A416 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…
$106.90
A415 Consultation
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon who requests the opinion of a…
$159.45

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.

A new written request signed by the referring provider must be kept in the consultant's medical record.

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

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

Usage limits

Not subject to the standard limit of one consultation per two consecutive 12-month periods (which applies to A415), provided the definition of a repeat consultation is met (intervening care by another physician).

A415Consultation A545Limited consultation A413Medical specific assessment C416Repeat consultation (In-patient)

If the requirements for a repeat consultation are not met (e.g., no new written request or no intervening care), the fee will be adjusted to a lesser assessment fee.

A416 is the out-patient/office version; C416 is the in-patient version.

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