C236 – Repeat consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A repeat consultation is an additional assessment 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. It has the same requirements as a consultation, including a new written request from a referring practitioner. This service is for non-emergency hospital in-patients, as indicated by the 'C' prefix. All consultations require a direct physical encounter with the patient, including a patient history and physical examination, and the preparation of a written report to the referring practitioner.
When to Use
- Use C236 when you have already provided an initial consultation (C235) for a specific condition, and the patient has since been managed by another physician (e.g., the attending hospitalist) before you are requested to reassess the same problem.
- Use C236 for a non-emergency hospital inpatient when a new, distinct written referral is received for a follow-up assessment of a previously consulted condition.
Common Pitfalls
- Billing C236 without a new, formal written request from the referring practitioner; a verbal request or a note in the chart is insufficient and will lead to a clawback.
- Confusing C236 with a subsequent hospital visit (C002/C003); C236 requires a formal referral and report, whereas subsequent visits do not.
- Failing to document that the patient was under the care of another physician in the interval between the initial consultation and the repeat consultation.
Billing Tips
- Ensure the written referral for C236 explicitly references the need for a repeat assessment of the specific presenting problem to distinguish it from a routine follow-up visit.
- Always confirm the referring practitioner's billing number is included in the request, as this is a mandatory audit requirement for all consultation codes.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
A repeat consultation has the same requirements as a consultation including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon.
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. As this is a hospital service, the written request may be contained on the common medical record.
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.
The consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring practitioner.
The limits applicable to all consultations, including time-based and age-specific consultation services, do not apply to repeat consultations.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.