C667 – Neurodevelopmental Consultation
OHIP Surgical Procedures Code — Paediatrics (26) · Schedule of Benefits
A neurodevelopmental consultation rendered to a non-emergency in-patient in an acute care hospital. This service is provided following a written request from a referring physician, nurse practitioner, or dental surgeon due to the complexity, seriousness, or obscurity of the case. It involves a comprehensive assessment and the preparation of a written report with findings, opinions, and recommendations for the referring practitioner. This service is subject to the same conditions as outlined for A667.
When to Use
- Use C667 for an initial inpatient neurodevelopmental assessment of a child with complex conditions like autism or global developmental delay, provided a formal written referral is present.
- Choose C667 over C020 or C025 when the complexity of the neurodevelopmental case warrants a comprehensive consultation report rather than a standard hospital visit.
Common Pitfalls
- Failure to document the exact start and stop times in the medical record will result in an automatic reduction of the fee to a lower assessment code.
- Billing C667 when the patient has already been seen by the same physician for the same condition within the previous 12 months, which violates the once-per-year frequency limit.
- Attempting to bill C667 without a formal written referral request from a physician, nurse practitioner, or dental surgeon on file, which leads to immediate rejection or audit clawbacks.
Billing Tips
- Ensure the written report is sent to the referring practitioner promptly, as the absence of this report invalidates the consultation status and triggers a payment reduction to a lesser assessment fee.
- If the patient is under 16, always verify if an age premium applies, as these are stackable with the base C667 fee to increase the total reimbursement.
Effective: June 1, 2025
Consultations and Visits
Paediatrics (26)
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
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.
A written report including findings, opinions, and recommendations must be prepared and sent to the referring practitioner.
The start and stop time must be recorded in the patient’s permanent medical record or the payment for this service will be reduced to a lesser fee.
Paediatric patient
Neurodevelopmental consultation - subject to same conditions as A667.
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