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Billing code

A166A — Nephrology repeat consultation

Nephrology repeat consultation

A nephrologist bills A166 for another consultation on the same problem after another physician cared for the patient in between.

Watch for: Needs a new written request with the referrer's billing number on the claim; virtually, by video only, not telephone.

Code

A166A

Description

Nephrology 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 nephrology consultation: same nephrologist, same problem, after another physician's care in between. Needs a new written request.

What it covers

A repeat consultation is by the same consultant for the same presenting problem, after another physician has cared for the patient since your first consultation. It needs a new written request (GP19).

A166 is the nephrology office version; the full consultation is A165 (A136).

Billing rules

• Needs a new written, signed request from the referring physician or nurse practitioner (GP19).
• Repeat consultations do not count toward the consultation limits; if the repeat-consultation conditions aren't met, it is paid as an assessment (GP18).
• Detention (K001) can start only after 60 minutes and is assessed on an IC basis with a written explanation (GP30–GP31).
• Age premiums apply for patients under 16, from +10% to +30% depending on age (GP64).
• Can be done by video only (not telephone); add K300A to the claim (Appendix J AJ2, A66).
• For chronic dialysis patients, consultations and visits to manage dialysis, its complications and end-stage renal disease are included in the weekly chronic dialysis team fee (G860–G865) and are paid at nil to other physicians (J39).

Common rejections

• ARF: The claim has no referring provider number. A consultation must follow a written referral that identifies the referring physician or nurse practitioner and their billing number (GP16).
• AT2: Billed by telephone (K301A). This code is on Appendix J's video-only list, so it must be done by video and claimed with K300A (AJ2).

Related codes: A165, A865, A160, A164, C166

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Nephrology (16), page A136; rules GP18–GP19.

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