What is OHIP billing code W086?

W086 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W086 pay?

The current OHIP fee for W086 is $62.80, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W086 to OHIP?

W086 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W086 claims against the Schedule of Benefits rules before submission.

What codes are related to W086?

Codes related to W086 in the Schedule of Benefits include W085.

All codes

W086

W086 – Repeat consultation

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

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Levels of this visit

The W08x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W086 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
W085 Consultation
This service is for a non-emergency consultation by a Plastic Surgeon for a patient in a Long-Term Care Institution, which includes Chronic Care Hospitals, Convalescent Hospitals…
$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. A repeat consultation has the same requirements as a consultation, as defined on of the Schedule, including the requirement for a new written request from a referring physician, nurse practitioner, or dental surgeon. The consultant is required to perform an assessment and prepare a written report (including findings, opinions, and recommendations) for the referring provider.

Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon

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. In a facility with a common medical record, the written request may be on the common record.

The request must identify the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identify 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.

A written report including findings, opinions, and recommendations must be prepared and sent to the referring physician, nurse practitioner or dental surgeon.

W085

Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds.

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .

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