A795 – Geriatric psychiatric consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A geriatric psychiatric consultation is a comprehensive assessment rendered by a psychiatrist for a patient aged 75 years or older. It must include all elements of a standard psychiatric consultation (A195) and requires a minimum of 75 minutes of direct contact with the patient. The service must be scheduled at least 24 hours in advance, and the start and stop times must be documented in the medical record.
When to Use
- Bill A795 for a psychiatrist's comprehensive assessment of a patient aged 75 or older presenting with new-onset cognitive decline and behavioral changes, requiring at least 75 minutes of direct patient interaction.
- Use A795 when a psychiatrist performs a detailed psychiatric evaluation for a patient 75+ with complex medication management issues and co-morbid medical conditions, exceeding the time requirements of a standard consultation (A195).
- A795 is appropriate for a psychiatrist's in-depth assessment of a patient aged 75+ experiencing severe depression and suicidal ideation, necessitating a thorough evaluation beyond the scope of a brief visit.
Common Pitfalls
- Billing A795 when the direct patient contact time is less than the required 75 minutes; ensure meticulous documentation of start and stop times.
- Failing to obtain and retain a written request for consultation from the referring physician, nurse practitioner, or dental surgeon, which is a mandatory requirement for A795.
- Submitting A795 for a patient under 75 years of age; this code is strictly limited to patients 75 and older.
Billing Tips
- Ensure the consultation is scheduled at least 24 hours in advance and document this in the patient's chart to meet the A795 scheduling requirement.
- If additional time beyond the initial 75 minutes is required for the geriatric psychiatric consultation, consider billing K630 (Psychiatric consultation extension) in conjunction with A795, adhering to its specific time and unit requirements.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Psychiatry
Consultation
Must include all constituent elements of a consultation (A195).
Minimum of 75 minutes in direct contact with the patient.
Time spent in discussion with caregivers or rendering other separately billable interventions is excluded from the 75-minute minimum.
The consultation must be scheduled a minimum of 24 hours prior to the visit.
Start and stop times must be recorded in the patient's permanent medical record.
A written report must be provided to the referring physician or nurse practitioner.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record.
patient aged 75 years or older
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