Billing code
A486A — Rheumatology repeat consultation
Repeat rheumatology consultation
Bill A486 when you consult again on the same problem after another physician has cared for the patient in between.
Watch for: Needs a new written request, and another physician must have given care in between, or it's paid as an assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $125.10 | $0.00 | $0.00 | $0.00 |
- Code
- A486A
- Description
- Rheumatology 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 rheumatology consultation: the same rheumatologist, same problem, after another physician gave care in between. Needs a new referral.
What it covers
A486 is a repeat consultation: an additional consultation by the same consultant for the same presenting problem, after the patient was cared for by another physician in the interval since the first consultation (GP19).
It has the same requirements as a consultation, including a new written request from the referring physician or nurse practitioner (GP19).
Billing rules
- Needs a new written, signed request, with all consultation requirements (GP16, GP19).
- Another physician must have provided care between the first consultation and the repeat; if not, it's paid as an assessment (GP18–GP19).
- Repeat consultations don't count toward the consultation limits (GP18).
- Detention (K001) may start after 60 minutes (GP30).
- Age premium of 10–30% for patients under 16 (GP64).
- 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: A485, A590, A595, C486, A484
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), page A200.
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