What is OHIP billing code C086?

C086 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C086 pay?

The current OHIP fee for C086 is $62.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C086 to OHIP?

C086 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C086 claims against the Schedule of Benefits rules before submission.

What codes are related to C086?

Codes related to C086 in the Schedule of Benefits include A086, W086, C085, C935.

All codes

C086

C086 – Repeat consultation

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

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Levels of this visit

The C08x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

C084 Specific re-assessment
A specific re-assessment is a service rendered by a specialist (Plastic Surgery, specialty 08) for a hospital in-patient.
$34.90
C083 Specific assessment
A specific assessment is a service rendered by a specialist (Plastic Surgery) for a hospital in-patient, requiring a full history of the presenting complaint and a detailed…
$54.40

Consultations

C086 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…
$62.80
C085 Consultation
A consultation rendered by a Plastic Surgeon following a written request from a referring physician, nurse practitioner, or dental surgeon, including a review of relevant data…
$106.25

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. This specific code (C086) applies to Plastic Surgery (08) services rendered to non-emergency hospital in-patients.

A written request from a referring physician, nurse practitioner, or dental surgeon is mandatory.

A new written request is required for each repeat consultation.

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

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

Usage limits

Not subject to the general limit of one consultation per two consecutive 12-month periods for the same diagnosis ( Note 1).

A086Repeat consultation (Office/General)W086Repeat consultation (Long-Term Care)C085Consultation (Hospital In-patient)C935Special surgical consultation (Hospital In-patient)

Age-based fee premiums (10% to 30%) apply for patients under 16 years of age.

If the requirements for a repeat consultation are not met (e.g., no new referral or no care by another physician in the interval), the fee will be adjusted to a lesser assessment fee.

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