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Billing code

C066A — Orthopaedic surgery in-patient repeat consultation

Orthopaedic in-patient repeat consultation

Bill C066 when the same orthopaedic surgeon consults again on an in-patient's same problem after another physician's care in between.

Watch for: Needs a new signed written request with the referrer's billing number; otherwise OHIP pays an assessment instead.

Code

C066A

Description

Orthopaedic surgery in-patient 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 consultation by the same orthopaedic surgeon for a hospital in-patient, same problem, after another physician gave care in between.

What it covers

C066 is the Orthopaedic Surgery (06) repeat consultation for non-emergency hospital in-patients (A164). 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, and needs a new written request (GP19).

Billing rules

• Needs a new written, signed request naming the referrer and their billing number, and the patient and health number (GP16, GP19).
• If the repeat consultation requirements aren't met, OHIP pays an assessment instead (GP17–GP18).
• Repeat consultations don't count toward the consultation limits (GP18).
• Send a written report with your findings, opinion and recommendations to the referrer, and also to the primary care provider when a nurse practitioner referred (GP16).
• Age premiums of 10% to 30% apply to specialist consultations for patients under 16 (GP64).
• For emergency calls and other special visits to in-patients, use the General Listings (A-prefix) and special visit premiums instead (A164, GP65–GP78).
• Video only, with K300A. For in-patients, virtual care is paid only if you aren't the MRP, the hospital has no physician on staff with the needed expertise (documented by the referrer), and for a consultation the referrer saw the patient in person in the previous 30 days (AJ2, A69, A70).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (GP16).
• EQ6: OHIP describes this as 'Referring provider number not registered with the Ministry': check the referrer's billing number against the written request and resubmit (GP16).
• AT2: OHIP describes this as 'Must include video modality': this code is video-only in Appendix J, so it can't be billed by phone with K301A (AJ2).

Related codes: C065, C935, C063, C064, A066

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Orthopaedic Surgery (06), page A164. Repeat consultation rules GP19.

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