What are the billing rules for A316A?

Has the same requirements as a consultation, including a new written request from the referring physician or nurse practitioner (GP19). If the repeat consultation rules are not met, it is paid as an assessment (GP18). Repeat consultations do not count toward the consultation limits (GP18).

What is A316A often billed with?

K001 detention after 60 minutes (GP30).

Why is A316A rejected?

ARF: The referring provider number is missing. A consultation needs a written request that names the referring physician or nurse practitioner and their billing number (GP16). AT2: This code may be billed by video only (Appendix J, AJ2). A virtual claim must carry K300A, not K301A (telephone).

< Billing codes

Billing code

A316A — Physical medicine and rehabilitation repeat consultation

Q: What is OHIP billing code A316A?

Second consultation by the same physiatrist for the same problem, after another physician cared for the patient in between.

Physiatry repeat consultation

A physiatrist bills A316 for a second 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.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$106.60	$0.00	$0.00	$0.00

Code: A316A
Description: Physical medicine and rehabilitation 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

Second consultation by the same physiatrist for the same problem, after another physician cared for the patient in between.

What it covers

A repeat consultation is another consultation by the same consultant for the same presenting problem, after another physician has cared for the patient since the first consultation (GP19).

A316 is the Physical Medicine & Rehabilitation (31) repeat consultation in the General Listings (A175).

Billing rules

Has the same requirements as a consultation, including a new written request from the referring physician or nurse practitioner (GP19).
If the repeat consultation rules are not met, it is paid as an assessment (GP18).
Repeat consultations do not count toward the consultation limits (GP18).
Specialist consultations, limited consultations and repeat consultations get an age premium: +30% under 30 days, +25% to 1 year, +20% to 2 years, +15% to 5 years, +10% to 16 years (GP64).
Can be done by video only, never by telephone; bill the code with K300A (Appendix J AJ2, A70).

Often billed with

K001 detention after 60 minutes (GP30).

Common rejections

ARF: The referring provider number is missing. A consultation needs a written request that names the referring physician or nurse practitioner and their billing number (GP16).
AT2: This code may be billed by video only (Appendix J, AJ2). A virtual claim must carry K300A, not K301A (telephone).

Related codes: A315, A515, A425, C316, W516

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Physical Medicine & Rehabilitation (31), page A175.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing