What are the billing rules for A356A?

Needs a new written, signed request and all consultation requirements (GP16, GP19). Repeat consultations don't count toward the consultation limits; if the repeat rules aren't met, it is paid as an assessment (GP18). Starred (*) urology consults and assessments may include a genito-urinary exam and, when needed, urethral calibration, catheterization and prostatic fluid examination, but not endoscopy (A207).

Why is A356A rejected?

ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16). AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual care list, so it can't be billed by telephone (K301A) (Appendix J).

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Billing code

A356A — Urology repeat consultation

Q: What is OHIP billing code A356A?

Repeat urology consultation: same urologist, same problem, after another physician's care in between. Needs a new referral.

Urology repeat consultation

A urologist bills A356 for another consultation on the same problem after another physician cared for the patient in between.

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

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$64.90	$0.00	$0.00	$0.00

Code: A356A
Description: Urology 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 urology consultation: same urologist, same problem, after another physician's care in between. Needs a new referral.

What it covers

A repeat consultation is an additional consultation by the same consultant for the same presenting problem after another physician cared for the patient in the interval (GP19).

It has the same requirements as a consultation, including a new written request (GP19).

Billing rules

Needs a new written, signed request and all consultation requirements (GP16, GP19).
Repeat consultations don't count toward the consultation limits; if the repeat rules aren't met, it is paid as an assessment (GP18).
Starred (*) urology consults and assessments may include a genito-urinary exam and, when needed, urethral calibration, catheterization and prostatic fluid examination, but not endoscopy (A207).
Age premium of 10–30% for patients under 16 (GP64).
Detention (K001) may start after 60 minutes (GP30).
Video only (not telephone) as virtual care, with K300A (Appendix J, A66).

Common rejections

ARP: OHIP describes this as 'Referring Physician Number Required': a consultation needs the referring physician's or nurse practitioner's billing number (GP16).
AT2: OHIP describes this as 'Must Include Video Modality': this code is on the video-only virtual care list, so it can't be billed by telephone (K301A) (Appendix J).

Related codes: A355, A935, A353, C356

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Urology (35), page A206.

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