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Billing code

W266A — Paediatric repeat consultation – long-term care

LTC paediatric repeat consultation

Bill for the same paediatrician's repeat consultation on the same problem after another physician cared for the patient in between.

Watch for: Needs a new written request; put the referrer's billing number on the claim.

Code

W266A

Description

Paediatric 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

Second consultation by the same paediatrician for the same problem in long-term care, after another physician gave care in between.

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).

W266 is the Paediatrics (26) code for a non-emergency long-term care in-patient (A174).

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).
• Non-emergency long-term care in-patient service: chronic care and convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent beds, but not designated palliative care beds. Emergency calls and special visits use the General Listings (A prefix) with premiums (A174, GP49).
• 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).

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).

Related codes: A266, C266, W265, W565

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Paediatrics (26), page A174.

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