A198 – Consultative interview with patient less than age 22
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Consultative interview on behalf of disturbed patient (including report) - consultative interview with patient less than age 22
When to Use
- Bill A198 for a comprehensive psychiatric assessment of a patient under 22 who presents with significant behavioral disturbances, requiring a minimum of 60 minutes of direct physician-patient interaction.
- Use A198 when a referring physician requests a formal psychiatric consultation for a patient less than 22 years old exhibiting symptoms suggestive of a serious mental health condition, necessitating a detailed report of findings and recommendations.
- A198 is appropriate for a patient under 22 requiring an in-depth psychiatric evaluation, distinct from a brief assessment or follow-up, where the physician spends at least 60 minutes directly with the patient.
Common Pitfalls
- Billing A198 when the patient is 22 years of age or older; ensure the patient is strictly less than 22.
- Failing to obtain a written request from a referring provider; this is a mandatory requirement for A198.
- Not preparing and submitting a written report to the referring physician; this is a required component of the A198 service.
- Billing A198 for less than the required 60 minutes of direct patient contact; time spent on chart review or other non-patient-facing activities does not count towards this minimum.
Billing Tips
- If A197 (consultative interview with parent(s) or patient representative(s) of patient < age 22) and A198 are billed on the same day for the same patient, ensure the combined direct contact time meets the 120-minute minimum before considering K630.
- A198 can be extended with K630 (Psychiatric consultation extension) for time spent beyond the initial 60 minutes, with the first unit of K630 requiring a total minimum of 76 minutes (60 for A198 + 16 for K630).
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Psychiatry (19)
Consultation
patient less than age 22
If A197 and A198 are rendered to the same patient on the same day, the minimum combined time required before the first unit of K630 is payable is 120 minutes (total 136 minutes for consultation + 1 unit of K630).
Calculation of time excludes time devoted to other separately billable interventions and non-patient-facing time (e.g., chart review).
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