Billing code
A226A — Repeat Consultation
Genetics repeat consultation
A geneticist bills A226 for a second consultation on the same problem after another physician cared for the patient, on a new referral.
Watch for: Needs a new written request; enter that referrer's six-digit billing number on the claim, or it pays as an assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $119.40 | $0.00 | $0.00 | $0.00 |
- Code
- A226A
- Description
- 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
Genetics (22) repeat consultation: a geneticist's second consultation for the same problem after another physician's care, on a new referral.
What it covers
A226 is the repeat consultation in the Genetics (22) listing, which specialists with FCCMG designation may also use (A111).
A repeat consultation is an additional consultation by the same consultant for the same presenting problem, after another physician has cared for the patient since the first consultation. It needs a new written request and a written report back, like any consultation (GP16, GP19).
Billing rules
- Needs a new written, signed request naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart (GP16, GP19).
- If the repeat consultation requirements aren't met, it is paid as a general or specific assessment, depending on the specialty (GP17, GP18).
- Not counted in the consultation limits of one per two consecutive 12-month periods (GP18).
- Detention (K001) can only start after 60 minutes (GP30).
- Patients under 16: specialist consultation age premium of 10% to 30% (GP64).
- Video only (with K300A), never telephone (AJ2).
Common rejections
- AC4: The referring provider number was missing, mistyped, your own number, or from a provider type that can't refer. A repeat consultation needs a new written request, so enter that referrer's six-digit number (GP19).
Related codes: A225, A220, A223, A325, A221, K222, C226
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Genetics (22), page A111; General Preamble GP16 to GP19 (consultations, repeat consultation)
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