What is OHIP billing code C026?

C026 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C026 pay?

The current OHIP fee for C026 is $47.75, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C026 to OHIP?

C026 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C026 claims against the Schedule of Benefits rules before submission.

What codes are related to C026?

Codes related to C026 in the Schedule of Benefits include C025, A026, W026.

All codes

C026

C026 – Repeat consultation

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

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Levels of this visit

The C02x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C024 Specific re-assessment
A specific re-assessment is a service rendered by a specialist in a hospital in-patient setting (non-emergency) that requires a full, relevant history and physical examination of…
$27.25
C023 Specific assessment
Specific assessment, Dermatology (02), non-emergency hospital in-patient services (see General Preamble GP40 to GP48).
$46.15
C020 Complex dermatology assessment
A complex dermatology assessment is an in-patient assessment for the ongoing management of specific complex dermatological diseases where the complexity of the condition requires…
$60.00

Consultations

C026 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…
$47.75
C025 Consultation
A consultation rendered to a non-emergency hospital in-patient by a Dermatology specialist following a written request from a referring physician, nurse practitioner, or dental…
$158.15

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 prepare a written report (findings, opinions, and recommendations) to the referring provider.

The service must include a general, specific, or medical specific assessment, including a review of all relevant data.

Care must have been rendered to the patient by another physician in the interval between the initial consultation and the repeat consultation.

The consultant must be the same physician who performed the initial consultation.

Usage limits

Not subject to the limit of one consultation per two consecutive 12-month periods that applies to regular consultations.

C025Consultation (Dermatology - Hospital In-patient)A026Repeat consultation (Dermatology - General Listing)W026Repeat consultation (Dermatology - Long-term care)

If the requirements for a repeat consultation are not met, the amount payable will be adjusted to a lesser assessment fee.

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