A726 – Repeat consultation - Occupational Medicine
OHIP General Listings Code · 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 A726 when an occupational medicine specialist sees a patient for the same work-related injury or illness, after the patient has been managed by their family physician for a period.
- Use A726 if the patient returns to the same occupational medicine specialist for the same presenting problem, but only after another physician has provided care in the interim.
- A726 is appropriate when a new referral is received for a patient previously seen by the same occupational medicine consultant for the same issue, following a period of care by a different physician.
Common Pitfalls
- Billing A726 without a new, signed written request from the referring provider for each repeat consultation will lead to claim rejection.
- Failure to include a written report detailing findings, opinions, and recommendations to the referring provider will result in fee adjustment.
- Submitting A726 when the patient has not received care from another physician between the initial and repeat consultation by the same specialist is incorrect.
Billing Tips
- Ensure the written request for A726 clearly identifies the patient, referring provider (with OHIP billing number), and the consultant by name and/or specialty.
- Remember that A726 is distinct from A725 (Consultation) and should only be used when care has been provided by another physician between the initial and repeat consultation for the same presenting problem.
Effective: April 1, 2026
Consultation
Consultation
A new written request from the referring provider is required for each repeat consultation.
The consultant must provide a written report (findings, opinions, and recommendations) to the referring provider.
The service must follow care rendered by another physician in the interval since the initial consultation.
The consultant must perform a general, specific, or medical specific assessment as part of the service.
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.
If the requirements for a consultation (e.g., written request, report) are not met, the fee will be adjusted to a lesser assessment fee.
Eligible for age-based fee premiums for patients under 16 years of age (30% for <30 days, 25% for 30 days to <1 year, 20% for 1-2 years, 15% for 2-5 years, 10% for 5-16 years).
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