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Billing code

A066A — Orthopaedic surgery repeat consultation

Orthopaedic repeat consultation

An orthopaedic surgeon bills A066 for another consultation on the same problem after another physician cared for the patient in between.

Watch for: Needs a new written, signed request and the referrer's billing number on the claim; otherwise OHIP pays an assessment instead.

Code

A066A

Description

Orthopaedic surgery repeat consultation

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Repeat consultation by the same orthopaedic surgeon for the same problem, after another physician has cared for the patient in between.

What it covers

A066 is the Orthopaedic Surgery (06) repeat consultation (A164). A repeat consultation is another consultation by the same consultant for the same presenting problem, after another physician has given the patient care since the first consultation (GP19).

It has the same requirements as a consultation, including a new written request from the referring physician or nurse practitioner (GP19).

Billing rules

• Specialists bill from the Consultations and Visits listing of their own specialty, here Orthopaedic Surgery (06) (GP9).
• Needs a new written, signed request naming the referrer and their billing number, and the patient and health number (GP16, GP19).
• If the repeat consultation requirements aren't met, OHIP pays an assessment instead (GP17–GP18).
• Repeat consultations don't count toward the consultation limits (GP18).
• Send a written report with your findings, opinion and recommendations to the referrer, and also to the primary care provider when a nurse practitioner referred (GP16).
• Age premiums of 10% to 30% apply to specialist consultations for patients under 16 (GP64).
• Can be done by video only, not phone, with modality indicator K300A (AJ2, A70).

Often billed with

• K001 detention, after the first 60 minutes (GP29–GP30).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
• EQ6: OHIP describes this as 'Referring provider number not registered with the Ministry': check the referrer's billing number against the written request and resubmit (GP16).
• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: A065, A935, A063, A064, C066, W066

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Orthopaedic Surgery (06), page A164. Repeat consultation rules GP19.

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