C006 – Repeat consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
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
- Use C006 when a patient is re-referred to you for the same condition after an intervening period where they were managed by a different physician, such as a primary care provider or another specialist.
- Use C006 when a patient is readmitted to the hospital for the same chronic issue that you previously consulted on, provided another physician managed the patient during the discharge interval.
Common Pitfalls
- Billing C006 without a new, distinct written referral request for the repeat consultation will result in a rejection or downgrade to a lower assessment fee.
- Attempting to bill C006 when you have provided continuous care for the same problem without an intervening period of management by another physician is a common audit trigger.
- Failing to document the specific interim care provided by another physician in your consultation note makes the claim vulnerable to recovery during a post-payment audit.
Billing Tips
- Ensure the referring physician's billing number is explicitly recorded on the new referral request to satisfy the mandatory documentation requirements for C006.
- Attach the appropriate Special Visit Premium (SVP) if the repeat consultation is non-elective and meets the criteria for an urgent hospital visit, as C006 is eligible for these premiums.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-patient
Consultation
A new written request is mandatory.
A written report must be provided to the referring provider.
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 repeat consultation are not met (e.g., no new referral or no interim care by another doctor), the fee will be adjusted to a lesser assessment fee.
Listed under Non-Emergency Hospital In-Patient Services.
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