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A466 – Repeat consultation

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

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Levels of this visit

The A46x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A468 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…

    $62.15

  • A464 Medical specific re-assessment

    A medical specific re-assessment is a service rendered by a specialist that requires a full, relevant history and physical examination of one or more systems.

    $82.10

  • A461 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.

    $95.05

  • A463 Medical specific assessment

    A service rendered by an infectious disease specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination of…

    $107.00

Consultations

  • A466 Repeat consultation(this code)

    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…

    $124.00

  • A465 Consultation

    A consultation rendered by an infectious disease specialist following a written request from a referring physician, nurse practitioner, or dental surgeon.

    $205.90

  • A460 Comprehensive infectious disease consultation

    A comprehensive infectious disease consultation requiring a minimum of 75 minutes in direct contact with the patient, satisfying all elements of a consultation as defined in the…

    $342.25
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 be competent to give advice in the field due to the complexity, seriousness, or obscurity of the case.
The service must include a general, specific, or medical specific assessment.
A written report (findings, opinions, and recommendations) must be sent to the referring provider.
The written request must be signed and kept in the consultant's medical record (except in hospitals with common records).
The request must identify the consultant, referring provider (name and billing number), and patient (name and health number).
The request must specify the service required and relevant clinical information.
Usage limits
Not subject to the one-per-24-month limit for consultations, provided the criteria for a repeat consultation are met (specifically the requirement for intervening care by another physician).
A465Infectious Disease ConsultationA460Comprehensive Infectious Disease ConsultationA275Infectious Disease Limited ConsultationC466Infectious Disease Repeat Consultation (In-patient)

A repeat consultation is only payable if care was rendered to the patient by another physician in the interval between the initial consultation and the repeat consultation.

If the physician who was paid for a consultation makes a request for a referral for ongoing management, the subsequent service is not payable as a consultation.

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