What is OHIP billing code W226?

W226 is "Repeat consultation", an OHIP Consultations and Visits code from the Ontario Schedule of Benefits (Physician Services).

How much does W226 pay?

The current OHIP fee for W226 is $119.40, effective 2026-04-01, per the Ontario Schedule of Benefits.

How do I bill W226 to OHIP?

W226 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates W226 claims against the Schedule of Benefits rules before submission.

What codes are related to W226?

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

All codes

W226

W226 – Repeat consultation

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

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Levels of this visit

The W22x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

W226 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…
$119.40
W225 Consultation
A consultation service provided by a specialist in Genetics (22).
$190.50
W220 Special genetic consultation
A special genetic consultation rendered to a patient in a non-emergency long-term care institution setting, as defined in GP49.
$342.25
W223 Extended special genetic consultation
An extended special genetic consultation rendered to a patient in a non-emergency, long-term care in-patient setting.
$442.40

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 including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon. This service applies when rendered by a Genetics specialist in a non-emergency long-term care in-patient setting.

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, 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, 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.

A226 C226

*A consultation is payable at nil if a genetic assessment (K016) or genetic care (K222) has previously been claimed by the same physician.

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