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A102 – Limited Virtual Care by Telephone

OHIP Consultations and Visits 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.
The service must be initiated by the patient or the patient’s representative, or represent a medically necessary follow-up to a preceding visit initiated by the patient.
The delivery modality (Telephone) must be documented in the patient's medical record.
The physician must provide a medically appropriate exam (as permitted by audio) to arrive at a diagnosis and management plan.

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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