A906 – GP focused practice limited consultation by Video
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A limited consultation rendered by a GP Focused Practice Physician via Video, requiring a full, relevant history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.
When to Use
- Use A906 for a focused assessment of a new, isolated dermatological issue (e.g., a rash on an arm) requested by a family physician, where a full history and targeted examination via video are sufficient.
- Bill A906 when a GP Focused Practice Physician provides a limited virtual assessment for a specific joint pain complaint, following a referral, and completes a targeted history and examination of the affected joint.
- A906 is appropriate for a follow-up virtual consultation on a stable, previously diagnosed condition (e.g., monitoring a minor medication side effect) where a brief, focused history and review of the affected system are needed, and a referral was obtained.
Common Pitfalls
- Billing A906 when the patient and physician are not both physically located in Ontario at the time of the virtual visit will lead to rejection.
- Failure to include the K300A modality indicator on the claim will result in the claim being rejected for incorrect submission.
- Submitting A906 without a documented written request from a referring physician, NP, or dental surgeon, or failing to maintain a copy in the chart, is a common audit risk.
Billing Tips
- Ensure the written report to the referring provider clearly outlines findings, opinions, and recommendations; this is a mandatory component for A906.
- Remember that A906 is a 'limited' consultation; if the service requires substantially more time or is more demanding, consider if A010 or other consultation codes are more appropriate.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Virtual Care
Consultation
Must be rendered following a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based insured dental procedures).
The consultant must prepare and submit a written report (findings, opinions, and recommendations) to the referring provider.
The request must identify the consultant, the referrer (name and billing number), and the patient (name and health number).
A copy of the signed written request must be maintained in the physician's medical record.
The service must be performed using a 'Verified-Virtual Visit Solution' (Ontario Health verified platform).
The delivery modality (Video) must be documented in the patient's medical record.
A limited consultation is defined as being less demanding and requiring substantially less time than a full consultation.
If the requirements for a consultation (e.g., written request/report) are not met, the fee will be adjusted to a lesser assessment fee.
Virtual Care Services are not eligible for payment for services provided to hospital inpatients or patients in a Long-Term Care institution unless all of the following requirements have been met: The physician providing the service is not the patient's MRP. The hospital/Long-Term Care institution does not have a physician on staff and present in the community with the expertise to render the necessary service, as documented by the referring physician in the patient’s medical record. An assessment with a direct physical encounter by the referring physician must have been completed within 30 days preceding a virtual in-patient specialist consultation to confirm the need for a consultation.
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