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A913
A913 – GP focused practice special consultation by Video
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation rendered by a GP Focused Practice Physician who completes a full, relevant history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function and who spends a minimum of 50 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
Requires a written request from a referring physician, nurse practitioner, or dental surgeon (in hospital settings).
A written report (including findings, opinions, and recommendations) must be prepared and sent to the referring provider.
The physician must spend a minimum of 50 minutes in direct contact with the patient.
Start and stop times must be recorded in the patient's permanent medical record.
The delivery modality (Video) must be documented in the medical record.
The service must be initiated by the patient or their representative, or be a medically necessary follow-up to a patient-initiated visit.
Usage limits
Limited to one service per two consecutive 12-month periods for the same diagnosis. Consultations for a clearly defined unrelated diagnosis are limited to one service every 12 months.
Calculation of the 50-minute minimum excludes time devoted to any other separately billable service.
Calculation of time excludes non-patient-facing time (e.g., reviewing charts, imaging, or documentation).
If the service cannot be appropriately completed without a direct physical encounter, the virtual service is not eligible for payment; only the subsequent in-person service may be claimed.
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