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C056 – Repeat consultation

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

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Levels of this visit

The C05x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • C054 Medical specific re-assessment

    A medical specific re-assessment is a service rendered by a specialist in an acute care hospital (non-emergency in-patient) requiring a full, relevant history and physical…

    $64.30

  • C051 Complex medical specific re-assessment

    A re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.

    $74.45

  • C053 Medical specific assessment

    A medical specific assessment rendered by a specialist in Community Medicine for a non-emergency hospital in-patient.

    $83.85

Consultations

  • C056 Repeat consultation(this code)

    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…

    $94.75

  • C055 Consultation

    A consultation rendered to a hospital in-patient by a specialist in Community Medicine (05) following a written request from a referring physician, nurse practitioner, or dental…

    $152.80

  • C050 Special community medicine consultation

    This service is a consultation rendered by a specialist in community medicine who provides all the appropriate elements of a consultation and spends a minimum of 50 minutes in…

    $176.10
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.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A new written request from a referring physician, nurse practitioner, or dental surgeon is mandatory.
The consultant must have previously seen the patient for the same problem.
Another physician must have provided care for the same problem in the interval between the initial and repeat consultation.
A written report including findings, opinions, and recommendations must be sent to the referring provider.
The consultant must perform a medical specific assessment and review all relevant data.
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.
Usage limits
Not subject to the 'one per 24 months' limit that applies to full consultations (C055/C050/C400).
C055ConsultationC405Limited consultationA056Repeat consultation (Office)W056Repeat consultation (Long-term care)C053Medical specific assessment

Repeat consultations are exempt from the standard consultation frequency limits defined in .

C056 is specifically for hospital inpatients; for office settings, use A056.

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