A667 – Neurodevelopmental Consultation
OHIP General Listings Code — Paediatrics (26) · Schedule of Benefits
A consultation in which the physician provides all the elements of a consultation (A265) for an infant, child or adolescent with complex neurodevelopmental conditions (e.g. autism, global development disorders etc.) and spends a minimum of 90 minutes in direct contact with the patient and caregiver, exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- Bill A667 for a comprehensive assessment of a child presenting with global developmental delay and suspected autism spectrum disorder, requiring a minimum of 90 minutes of direct interaction.
- Use A667 when evaluating a young child with a complex neurodevelopmental condition, such as cerebral palsy with associated cognitive impairments, where extensive time with the patient and family is necessary.
- A667 is appropriate for a detailed consultation concerning a child with a rare genetic syndrome known to cause significant neurodevelopmental challenges, necessitating a prolonged and in-depth evaluation.
Common Pitfalls
- Billing A667 when the patient's condition is less complex, such as isolated ADHD, which would be more appropriately billed under a different code like A265 or A260.
- Failing to record the precise start and stop times for the 90-minute direct patient/caregiver contact in the patient's medical record, leading to claim rejection or reduction.
- Including time spent on non-patient-facing activities like chart review or report writing in the 90-minute direct contact calculation, as this time is excluded.
Billing Tips
- Ensure the referral documentation clearly states the complex neurodevelopmental condition prompting the need for an extended consultation, aligning with the A667 criteria.
- When applicable, append the appropriate age premium codes (e.g., AGE_PREMIUM_30_DAYS, AGE_PREMIUM_1_YEAR) to A667 to accurately reflect the fee for very young patients requiring this specialized consultation.
Effective: June 1, 2025
Consultations and Visits
Paediatrics (26)
Paediatrics
Consultation
Written request from a referring physician, nurse practitioner, or dental surgeon must be kept in the consulting physician’s medical record (except in hospital, long-term care, or multi-specialty clinic where common medical records are maintained).
Written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon (and primary care provider if referral by NP).
Start and stop times must be recorded in the patient's permanent medical record.
Minimum 90 minutes of direct contact with patient and caregiver.
For an infant, child or adolescent.
Calculation of time excludes non-patient-facing time (chart review, imaging, documentation).
Neurodevelopmental consultations for less complex conditions (e.g. ADHD) are payable at a lesser fee.
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