Billing code
C486A — Rheumatology repeat consultation – hospital in-patient
Rheumatology in-patient repeat consultation
Bill for another rheumatology 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 and the referrer's billing number; otherwise it pays as an assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $124.50 | $0.00 | $0.00 | $0.00 |
- Code
- C486A
- Description
- Rheumatology 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 rheumatology consultation for an in-patient: same consultant, same problem, after another physician's care in between.
What it covers
C486 is a repeat consultation for a non-emergency hospital in-patient (A205): an additional consultation by the same consultant for the same presenting problem, after another physician cared for the patient in the interval (GP19).
It needs a new written request, like any consultation (GP19).
Billing rules
- C-prefix codes are for non-emergency services to acute hospital in-patients; emergency calls and special visits to in-patients use the A-prefix General Listings with premiums (A205, GP12).
- Needs a new written request and all consultation requirements (GP16, GP19).
- Repeat consultations don't count toward the consultation limits; if the repeat rules aren't met it's paid as an assessment (GP18).
- Age premium of 10–30% for patients under 16 (GP64).
- By video only, and for in-patients only when you aren't the MRP, no local physician with the expertise is available, and the referrer assessed the patient in person within the prior 30 days (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: C485, C590, A486, C484
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Rheumatology (48), Non-emergency hospital in-patient services, page A205.
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