1What Is the A906 OHIP Code?
A906 is an OHIP billing code designated for limited consultations via video in a focused GP practice. This code is particularly relevant for physicians working in areas such as addiction medicine or chronic pain management. These consultations are less demanding than comprehensive consultations and focus on specific assessment needs as per a narrow referral request.
The nature of the consultation is inherently brief, aimed at addressing specific clinical questions without the extensive requirements of a comprehensive consultation. Being eligible for billing as a video-based consultation only, it allows practitioners to provide remote, efficient patient assessments in their areas of specialization.
Physicians may miss billing this code correctly by not adhering to the necessary consultation criteria or by wrongfully using it for a medium other than video, such as phone consultations.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Subject to the same consultation frequency limits | Used when a comprehensive evaluation and recommendation are necessary. |
| A006 | Repeat consultation | Frequent use permissible as per specific guidelines | Employed when a follow-up after an initial consultation is necessary. |
| A010 | GP focused practice consultation by Video | Subject to the same consultation frequency limits | General GP-focused video consultation with broader scope. |
| A011 | GP focused practice repeat consultation by Video | Follow-up consultations within the frequency limits | For follow-ups after initial video consultations. |
3Eligibility Requirements
Eligible physicians for billing A906 are those designated by the MOH-OMA GP Focused Practice Review Committee or those eligible for the focused practice psychotherapy premium. The consultation must be rendered following a written request from a referring physician, nurse practitioner, or dental surgeon in connection with a hospital dental procedure. A906 is strictly a video-only service and cannot be billed for telephone interactions.
Physicians must ensure that these requirements are met to avoid a reduction in the payable amount to a lesser assessment fee. For a valid A906 claim, the service must be a limited consultation, meaning it requires substantially less physician time compared to a full consultation. In terms of billing frequency, consultations for the same patient, physician, and diagnosis are limited to one service every two consecutive 12-month periods, with certain exceptions aligned with repeat consultations or emergency department referrals.
4What Your Clinical Note Must Show
Ensure detailed documentation of the consultation process.
- Referral source details — include name and professional designation.
- Primary reason for consultation and specific question requiring focused advice.
- Consultation findings and recommendations — summarizing the main points discussed.
5Weak vs. Strong Note Examples
The strong note is successful because it clearly defines the referral source, specific consultation focus, and the outcomes addressed. The weak note, on the other hand, lacks specificity and fails to detail the consultation's scope or recommendations.
Patient Dr. John Doe was seen via video. Discussed general symptoms and provided verbal advice.
Dr. John Doe referred the patient for evaluation of chronic pain management strategies via video consultation.
Conducted a brief assessment focusing on previously documented therapy approaches, discussed efficacy, and proposed an adjustment in medication regimen.
- Referral from Dr. Jane Smith, GP.
- Specific request: Pain management optimization.
- Evaluation findings: Strength and weaknesses of current regimen.
