All codes
B601
B601 – B601
OHIP Paediatrics Code · Schedule of Benefits
When to Use
- B601 is appropriate for a specialist performing a consultation for a patient referred by another physician, where the patient's condition requires specialized diagnostic assessment and management planning.
- Use B601 when a specialist provides a comprehensive assessment and treatment plan for a complex condition that falls outside the scope of primary care, necessitating expert opinion and guidance.
- B601 is indicated for a specialist consultation where the patient presents with symptoms or a diagnosis requiring advanced diagnostic interpretation or therapeutic intervention not available from the referring physician.
Common Pitfalls
- Billing B601 for a routine follow-up visit that could be billed with an intermediate assessment code (e.g., A007) or a general assessment code (e.g., A001) is a common error.
- Submitting B601 when the patient's condition does not require a specialist consultation, such as for a minor ailment or a condition already managed by the referring physician, can lead to claim rejection.
- Failure to clearly document the referral and the specific specialist opinion provided in the patient's chart can result in audit issues if B601 is billed.
Billing Tips
- Ensure the patient's chart clearly indicates a referral from another physician and details the specific reason for the specialist consultation.
- Verify that the services provided align with the definition of a consultation, involving a comprehensive assessment and the formulation of a management plan, distinct from a simple assessment or follow-up.
Provider Fee$0.00
Specialist Fee$491.55
Effective: April 1, 2026
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