Billing code
W236A — Internal medicine repeat consultation – long-term care
LTC internal medicine repeat consult
Bill for an internist's repeat consultation on the same problem after another physician cared for the long-term care resident in between.
Watch for: Needs a new written request and the referrer's billing number; if virtual, it must be by video.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $123.10 | $0.00 | $0.00 | $0.00 |
- Code
- W236A
- Description
- Internal medicine repeat consultation – long-term care
- 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 long-term care resident: same consultant, same problem, after another physician's care in between.
What it covers
A repeat consultation is by the same consultant for the same presenting problem, after another physician has cared for the patient since your first consultation. It needs a new written request (GP19).
W236 is the long-term care (W-prefix) internal medicine version; the full LTC consultation is W235 (A131).
Billing rules
- Needs a new written, signed request from the referring physician or nurse practitioner (GP19).
- Repeat consultations do not count toward the consultation limits; if the repeat-consultation conditions aren't met, it is paid as an assessment (GP18).
- Detention (K001) can start only after 60 minutes and is assessed on an IC basis with a written explanation (GP30–GP31).
- Age premiums apply for patients under 16, from +10% to +30% depending on age (GP64).
- By video only, and for in-patients or LTC residents only when you are not the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer saw the patient in person within the prior 30 days (AJ2, A69).
Common rejections
- ARF: The claim has no referring provider number. A consultation must follow a written referral that identifies the referring physician or nurse practitioner and their billing number (GP16).
- AT2: Billed by telephone (K301A). This code is on Appendix J's video-only list, so it must be done by video and claimed with K300A (AJ2).
Related codes: W235, W435, W130, A136, C136
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Internal Medicine (13), page A131; rules GP19.
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