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Billing code

C196A — Psychiatry repeat consultation – hospital in-patient

Psychiatry in-patient repeat consultation

Bill for another psychiatric consultation on the same problem for a hospital in-patient after another physician cared for them in between.

Watch for: Needs a new written request with the referrer's billing number; without it, it pays as an assessment.

Code

C196A

Description

Psychiatry repeat consultation – hospital in-patient

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 psychiatric consultation for a hospital in-patient, for the same problem after another physician has cared for the patient in between.

What it covers

C196 is a repeat consultation by a psychiatrist for a non-emergency hospital in-patient (A186).

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

Billing rules

• Needs a new written request from the referring physician or nurse practitioner, like any consultation (GP19, GP16).
• If the repeat consultation rules aren't met, it is paid as an assessment (GP18).
• Repeat consultations don't count toward the consultation limits (GP18).
• For emergency calls and other special visits to in-patients, bill the General Listings (A-prefix) with the special visit premiums instead (A186, GP65–GP78).
• Virtual care: video only, not phone (AJ2). For an in-patient you must not be the MRP, the hospital must lack a local physician with the expertise (documented by the referrer), and for a consultation the referrer must have seen the patient in person within 30 days (A69).

Common rejections

• ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
• AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).

Related codes: A196, W196, C895, C395, C193

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A186. Rules GP16–GP19.

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