What are the billing rules for C136A?

Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Internal Medicine (13) (GP9). Needs a new written, signed request naming the referrer and their billing number (GP16, GP19). Repeat consultations don't count toward the consultation limits, but if the repeat-consultation conditions aren't met OHIP pays a general or specific assessment instead (GP18).

Why is C136A rejected?

ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation claim needs the referring physician's or nurse practitioner's billing number (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).

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Billing code

C136A — Internal medicine in-patient repeat consultation

Q: What is OHIP billing code C136A?

Repeat internal medicine consultation for a hospital in-patient: same consultant, same problem, after another physician's care in between.

Internal medicine in-patient repeat consultation

Bill C136 when the same internist consults again on an in-patient's same problem after another physician's care in between.

Watch for: Needs a new signed written request; if repeat conditions aren't met, OHIP pays a general or specific assessment.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.00	$123.10	$0.00	$0.00	$0.00

Code: C136A
Description: Internal medicine 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 internal medicine consultation for a hospital in-patient: same consultant, same problem, after another physician's care in between.

What it covers

C136 is the Internal Medicine (13) repeat consultation for non-emergency hospital in-patients (A130). A repeat consultation is another consultation by the same consultant for the same presenting problem, after another physician has cared for the patient in between. It needs a new written request (GP19).

Hospital in-patient (C-prefix) services follow GP40–GP48. For emergency calls and other special visits to in-patients, use the General Listings and special visit premiums instead (A130).

Billing rules

Specialists bill from the Consultations and Visits listing for their own Royal College specialty on file with the Ministry, here Internal Medicine (13) (GP9).
Needs a new written, signed request naming the referrer and their billing number (GP16, GP19).
Repeat consultations don't count toward the consultation limits, but if the repeat-consultation conditions aren't met OHIP pays a general or specific assessment instead (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).
Detention (K001) can be added only after 60 minutes of consultation time (GP30–GP31).
Video only (not phone), and for a hospital in-patient or LTC resident only if you are not the MRP, the facility has no physician with the needed expertise (documented by the referrer), and the referrer saw the patient in person within the past 30 days (AJ2, A69).

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).
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: C135, C435, A136, W236, C132

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A130. Consultation rules GP16–GP19.

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