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Billing code

C266A — Paediatric repeat consultation – hospital in-patient

Paediatric in-patient repeat consultation

Bill for another 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; otherwise it pays as an assessment.

Code

C266A

Description

Paediatric 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

Second consultation by the same paediatrician for the same problem, after another physician cared for the patient in between. In-patient.

What it covers

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 (GP19).

C266 is the Paediatrics (26) code for a non-emergency hospital in-patient (A173).

Billing rules

• Has the same requirements as a consultation, including a new written request from the referring physician or nurse practitioner (GP19).
• If the repeat consultation rules are not met, it is paid as an assessment (GP18).
• Repeat consultations do not count toward the consultation limits (GP18).
• Specialist consultations, limited consultations and repeat consultations get an age premium: +30% under 30 days, +25% to 1 year, +20% to 2 years, +15% to 5 years, +10% to 16 years (GP64).
• Non-emergency hospital in-patient service. For emergency calls and other special visits to in-patients, use the General Listings (A prefix) with premiums (A173, GP65–GP78).
• For a patient 18 or older, a paediatrician is paid only if they saw the patient from the Paediatrics general listings in the 12 months before the 18th birthday, ongoing management of a chronic condition is needed and the patient is under 22, or the MOH gave written prior approval (A168).
• Video only (never telephone) as virtual care (Appendix J, AJ2). For in-patients or long-term care residents, the virtual physician must not be the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer must have assessed the patient in person within 30 days (A69).

Often billed with

• K001 detention after 60 minutes (GP30).

Common rejections

• ARF: The referring provider number is missing. A consultation needs a written request that names the referring physician or nurse practitioner and their billing number (GP16).
• AT2: This code may be billed by video only (Appendix J, AJ2). A virtual claim must carry K300A, not K301A (telephone).

Related codes: A266, C265, C565, W266, C264

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Paediatrics (26), page A173.

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