What is OHIP billing code C226?

C226 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does C226 pay?

The current OHIP fee for C226 is $119.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill C226 to OHIP?

C226 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates C226 claims against the Schedule of Benefits rules before submission.

What codes are related to C226?

Codes related to C226 in the Schedule of Benefits include A226, W226.

All codes

C226

C226 – Repeat consultation

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

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Levels of this visit

The C22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

C226 Repeat consultation(this code)
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care rendered to the patient by another physician in…
$119.40
C225 Consultation
A consultation rendered by a specialist in Genetics (specialty 22) for a non-emergency acute care hospital in-patient.
$190.50
C220 Special genetic consultation
A special genetic consultation provided for a non-emergency hospital in-patient.
$342.25
C223 Extended special genetic consultation
An extended special genetic consultation for a non-emergency hospital in-patient.
$442.40

A repeat consultation is an additional consultation rendered by the same consultant for 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. As a 'C' prefix code, this service applies to non-emergency in-patient services in an acute care hospital. Service Requirements: • A new written request from a referring physician, nurse practitioner, or dental surgeon (for specific hospital procedures) is mandatory. The request must be kept in the consultant's medical record, identify all parties, and state the reason for the referral. (, ) • The service must include all the specific elements of an assessment as outlined in the Schedule of Benefits, such as a direct physical encounter, history taking, physical examination appropriate for the problem, and discussion with the patient or their representative. () • If the requirements for a repeat consultation are not met, the service will be paid as a lesser assessment fee. ()

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

A new written request from the referring physician, nurse practitioner, or dental surgeon is required.

A copy of the written request, signed by the referring practitioner, must be kept in the consulting physician's medical record (or on the common medical record in a hospital).

The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.

The written request must set out the information relevant to the referral and specify the service(s) required.

A226 W226

A consultation is payable at nil if genetic care (K222) has previously been claimed by the same physician.

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