A606 – Repeat consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
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.
When to Use
- Bill A606 when a patient returns for follow-up on the same presenting problem after seeing their GP for a new issue in the interim.
- Use A606 if the patient was initially seen by a different specialist for the same problem, and you are now re-evaluating them after they returned to their primary physician's care.
- A606 is appropriate when a patient requires a second opinion from you on a condition previously assessed by another consultant, and their primary care physician has managed them between these consultations.
Common Pitfalls
- Billing A605 instead of A606 when the patient has seen another physician for the same issue between your initial and repeat consultation.
- Submitting A606 when the patient has not seen another physician in the interval; this scenario requires a new A605 consultation.
- Using A606 for a new, unrelated presenting problem; this requires a separate A605 consultation.
Billing Tips
- Ensure the referral documentation clearly states the patient was seen by another physician for the same problem in the interim.
- Verify that a written report was sent to the referring physician, detailing findings, opinions, and recommendations, as this is a mandatory requirement for A606.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Office/Outpatient
Consultation
A written report (including findings, opinions, and recommendations) must be sent to the referring provider.
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.
The patient must have received care from another physician in the interval between the initial consultation and the repeat consultation.
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. In such cases, the written request may be contained on the common medical record.
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.
The written request sets out the information relevant to the referral and specifies the service(s) required.
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