A102 – Limited Virtual Care by Telephone
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A Limited Virtual Care Service is an assessment which includes at a minimum, history-taking and medically appropriate exam to arrive at a diagnosis and provide an appropriate management plan and/or management, and when provided, the other specific elements of assessments.
When to Use
- Bill A102 for a brief telephone assessment of a new patient presenting with a minor acute complaint, such as a rash or uncomplicated UTI, where a diagnosis and management plan can be established without a physical exam.
- Use A102 when a patient calls with a question about a new symptom and you do not have a prior physician-patient relationship, and the interaction is limited to history and advice.
- A102 is appropriate for a telephone follow-up of a patient seen for a previous unrelated issue, where the patient is not on your roster and no prior in-person visit has occurred within 24 months.
Common Pitfalls
- Billing A102 when an existing physician-patient relationship is present; in such cases, appropriate in-person codes with modality indicators should be used instead.
- Submitting A102 for physician-initiated calls or routine result reporting where no clinical management change occurs, as these are not payable.
- Using A102 when the service requires a physical examination that cannot be performed via telephone, leading to claim rejection or requiring billing of the subsequent in-person visit.
Billing Tips
- Document the telephone modality clearly in the patient's chart, as this is a requirement for A102 billing.
- Ensure the patient is not enrolled in your practice or has not had a direct physical encounter within the last 24 months to qualify for A102.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Virtual Care
Assessment
An Existing/Ongoing Patient-Physician Relationship is defined by: a direct physical encounter in the last 24 months, patient enrollment, a prior video consultation by a specialist in the last 24 months, or specific listed services (e.g., A920, A945) in the last 24 months.
If a relationship exists, the physician must bill the appropriate in-person fee code from Appendix J Section 1 with a modality indicator.
Virtual Care Services are not eligible for payment for hospital inpatients or LTC residents unless specific criteria regarding lack of local expertise and prior in-person assessment are met.
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