All codes
A695
A695 – Neurodevelopmental Consultation
OHIP General Listings Code — Psychiatry (19) · Schedule of Benefits
A neurodevelopmental consultation is a specialized psychiatric consultation for an adult with complex neurodevelopmental conditions (e.g., autism, global developmental disorders). It requires the physician to provide all elements of a standard psychiatric consultation (A195) and spend a minimum of 90 minutes in direct contact with the patient and caregiver.
When to Use
- Bill A695 for an initial comprehensive psychiatric assessment of an adult patient presenting with a long-standing, complex neurodevelopmental condition such as autism spectrum disorder, where the assessment requires extensive history taking and evaluation beyond a standard psychiatric consultation (A195).
- Utilize A695 when the patient's neurodevelopmental condition significantly impacts multiple life domains and requires a detailed assessment of cognitive, social, and adaptive functioning, necessitating a minimum of 90 minutes of direct patient and caregiver contact.
- Consider A695 for adults with global developmental disorders who require a specialized psychiatric evaluation to differentiate from other psychiatric comorbidities, ensuring the 90-minute direct contact requirement is met and documented.
Common Pitfalls
- Billing A695 for patients with less complex neurodevelopmental issues like uncomplicated ADHD, which should be billed under codes such as A195 or A395.
- Failing to document the start and stop times of the 90-minute direct patient and caregiver contact in the patient's medical record, leading to potential claim rejections or audits.
- Including time spent on non-patient-facing activities (e.g., chart review, report writing) or other separately billable procedures within the 90-minute minimum for A695.
Billing Tips
- Ensure the patient is an adult and has a complex neurodevelopmental condition; A695 is not appropriate for children, adolescents, or less complex presentations.
- Remember that A695 can only be billed once per patient per physician every 5 years, making accurate initial coding crucial.
Provider Fee$0.00
Specialist Fee$414.35
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Psychiatry (19)
Service Type
Psychiatry
Code Classes
Consultation
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