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Billing code

A070A — Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient

Geriatric special visit consultation

A geriatrician bills A070 for a consultation on a special visit to a hospital in-patient, long-term care resident or emergency department patient.

Watch for: Submit it with the matching C, W or K special visit premium and the referrer's billing number on the claim.

Code

A070A

Description

Consultation In Association With Special Visit To A Hospital In-patient, Long-term Care In-patient Or Emergency Department Patient

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

Geriatric consultation done on a special visit to a hospital in-patient, long-term care resident or emergency department patient.

What it covers

A070 is the Geriatrics (07) consultation for use with a special visit to a hospital in-patient, a long-term care in-patient or an emergency department patient (A118).

A consultation is an assessment done at the written request of a physician, nurse practitioner (or a dental surgeon for hospital dental work) who wants your opinion because the case is complex, serious or obscure, or because the patient asked for another opinion. It includes a general, specific or medical specific assessment, a review of relevant data and a written report to the referrer (GP16). A special visit is a visit the patient (or someone for them) asks for to get a non-elective service; in the patient's home it can be elective or non-elective (GP65).

Billing rules

• Submit A070 with the matching special visit premium: C-prefix for a hospital in-patient, W-prefix for a long-term care resident, or K-prefix for an ED patient (A118).
• Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Geriatrics (07) (GP9).
• Needs a written, signed request from a physician or nurse practitioner that names you or your specialty, the referrer and their billing number, and the patient and health number. Without it, OHIP pays a lesser assessment (GP16).
• Same patient, same consultant, same diagnosis: one consultation per two consecutive 12-month periods. A second is allowed only for a hospital in-patient or ED patient 12 to 24 months after the first; a clearly unrelated diagnosis allows one every 12 months. Extra consultations pay as an assessment (GP17–GP18).
• Special visit premiums are not payable for patients seen on rounds, for admission assessments of elective admissions, or for elective visits in long-term care (GP65–GP66).
• Record the time of the visit; in a hospital or LTC home it can go anywhere in the common record (GP69).
• Detention (K001) can be added only after 60 minutes of consultation time (GP30–GP31).
• Not on the Appendix J virtual care list, so it is not payable by video or phone (AJ1–AJ3).

Often billed with

• Hospital in-patient premiums, e.g. C960 travel and C990 first person seen (GP72).
• Long-term care premiums, e.g. W960 travel and W990 first person seen (GP73).
• Emergency department premiums, e.g. K960 travel and K990 first person seen (GP70).

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).

Related codes: A075, C075, W075, C990, W990, K990

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Geriatrics (07), page A118. Special visit premium rules GP65–GP74.

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