G470 – Ultraviolet light therapy
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Ultraviolet light therapy (general or local application) and/or Psoralen plus Ultraviolet A (PUVA) is an insured service only for treatment of dermatological conditions. Usage Limit: Maximum 1 per patient per day. Ineligible Settings: G470 is payable at nil (and therefore not a fee-for-service claim) if rendered in a hospital in-patient or out-patient department, or a physiotherapy clinic prescribed as a health facility under sub-section 35(10) under Regulation 552 of the Health Insurance Act. Delegation: This service can be delegated to a non-physician employee under the conditions outlined in the General Preamble (, ).
When to Use
- Use G470 for the administration of phototherapy for chronic dermatological conditions like psoriasis or vitiligo in a private office setting.
- Use G470 when a delegated staff member performs the light therapy session under your supervision as per GP62/GP63 requirements.
Common Pitfalls
- Billing G470 in a hospital-based clinic or a facility designated under Regulation 552 will result in a nil payment.
- Submitting G470 on the same day as a counselling code like K013 or K033 will trigger a rejection due to the restriction on concurrent psychotherapy/counselling services.
- Exceeding the daily limit of one service per patient will result in automatic rejection of the second claim.
Billing Tips
- Ensure your office location is not registered as a physiotherapy clinic under the Health Insurance Act to avoid automatic nil payment status for this code.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Procedure
Diagnostic and Therapeutic Procedures, Delegated Procedure
All insured services must be documented in appropriate records to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
G470 is an insured service payable at nil if rendered in a hospital in-patient or out-patient department or physiotherapy clinic prescribed as a health facility under sub-section 35(10) under Regulation 552 of the Health Insurance Act.
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