A662 – Extended Special Paediatric Consultation
OHIP General Listings Code — Paediatrics (26) · Schedule of Benefits
A consultation in which the physician provides all the elements of a consultation (A265) and spends a minimum of 90 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- Bill A662 when a complex paediatric patient requires a minimum of 90 minutes of direct physician contact for a comprehensive assessment, exceeding the time required for a standard consultation (A265) or a shorter paediatric consultation (A260).
- Use A662 for initial assessments of rare paediatric genetic disorders or complex congenital anomalies that necessitate extensive history taking, physical examination, and discussion of management options.
- Consider A662 for prolonged management planning sessions for paediatric patients with multiple chronic conditions requiring coordination of care across various subspecialties, provided the 90-minute direct contact threshold is met.
Common Pitfalls
- Billing A662 when the total direct patient contact time is less than 90 minutes; this will result in payment adjustment to a lesser fee, likely A265.
- Failing to obtain and document a written request from a referring physician, nurse practitioner, or dental surgeon, which is a mandatory requirement for A662.
- Submitting A662 when significant portions of the time were spent reviewing external records or preparing reports, as only direct patient contact time counts towards the 90-minute minimum.
Billing Tips
- Ensure the patient's chart clearly documents the start and end times of the 90-minute (or longer) direct patient contact to support the A662 claim.
- Always include a detailed written report to the referring provider outlining findings, opinions, and recommendations, as this is a key component of the A662 service.
Effective: June 1, 2025
Consultations and Visits
Paediatrics (26)
Consultations and Visits
Consultation
Must meet all requirements of a consultation (A265), including a written request from a referring physician, nurse practitioner, or dental surgeon.
A written report (including findings, opinions, and recommendations) must be provided to the referring provider.
Minimum of 90 minutes in direct contact with the patient.
Start and stop times of the service must be recorded in the patient's permanent medical record.
Services are primarily for patients under 18 years. Eligibility for patients aged 18 to 21 requires either prior MOH approval or continuous care for a chronic condition that began before age 18. See notes for full details.
The calculation of time excludes time devoted to any other service or procedure for which an amount is payable in addition to the consultation.
The calculation of time excludes non-patient-facing time such as time spent reviewing charts, imaging, or documentation.
If consultation requirements (e.g., written request, report, or time) are not met, the amount payable will be adjusted to a lesser assessment fee.
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