A914 – Not found
OHIP General Listings 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 75 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- When a GP Focused Practice Physician provides a comprehensive virtual (video) consultation requiring a minimum of 75 minutes of direct patient contact for a complex new diagnosis or management plan, exceeding the scope of A010 or A906.
- When a GP Focused Practice Physician performs a detailed virtual (video) assessment for a patient with a chronic condition requiring extensive review of history, examination, and data, necessitating the longer time commitment of A914 over A913.
- When a GP Focused Practice Physician conducts a virtual (video) consultation for a patient referred for a second opinion on a complex issue, where a thorough history, detailed examination, and extensive data review are critical for diagnosis and management.
Common Pitfalls
- Billing A914 when the direct patient contact time is less than 75 minutes; this will result in payment adjustment to a lesser assessment fee.
- Failing to obtain and retain a written referral from a physician, NP, or dental surgeon, which is mandatory unless the consultation occurs in a hospital, LTC, or multi-specialty clinic with common records.
- Billing A914 for a service that requires a physical encounter, as per the same-day restriction, leading to non-payment.
Billing Tips
- Ensure the written report to the referring provider includes detailed findings, opinions, and specific recommendations, clearly outlining the consultant's assessment and plan.
- Accurately document the 75 minutes of direct patient contact time, ensuring it excludes any time spent on separately billable procedures or non-patient-facing activities like chart review.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Virtual Care (Video)
Consultation
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, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
Consultant must prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.
Time calculation excludes non-patient-facing time such as time spent reviewing charts, imaging, or documentation.
If the requirements for a consultation are not met (e.g., no written request, insufficient time), the amount payable will be adjusted to a lesser assessment fee.
Consultations rendered to the same patient by the same consultant with a clearly defined unrelated diagnosis are limited to one service every 12 months.
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