J714 – PET – Oncology
OHIP Cardio-Thoracic Surgery Code · Schedule of Benefits
Positron Emission Tomography (PET) scan for oncologic or suspected oncologic indications.
When to Use
- Use J714 for staging, restaging, or treatment response assessment of solid tumors that meet current Ontario Health approved oncologic indications.
- Use J714 when a PET/CT or PET/MR is performed specifically for the characterization of a suspected malignancy that falls within the established provincial clinical criteria.
Common Pitfalls
- Billing J714 for indications listed as 'evidence-building' or 'PET Registry' will result in automatic rejection as these are not insured under the Schedule of Benefits.
- Attempting to bill for the interpretation of the CT or MR component of the scan separately is a common audit trigger, as this is strictly included in the J714 fee.
- Submitting J714 alongside J715, J716, or J717 for the same patient on the same day will cause a claim rejection due to the daily limit restriction.
Billing Tips
- Ensure the claim uses suffix C for the professional component and verify that the technical component is not being claimed if the service was rendered in a hospital setting.
- Always cross-reference the specific clinical indication against the current Ontario Health PET scan guidelines before submission to ensure the procedure is not classified as an uninsured evidence-building service.
Effective: April 1, 2026
Nuclear Medicine - IN VIVO
Diagnostic
Must be performed for an approved 'Routine PET Scan' indication.
Requires the use of combined PET/CT or PET/MR equipment.
Interpretation of the CT or MR imaging performed as part of the PET study for attenuation correction and anatomic localization is not eligible for payment.
PET scanning for oncology must use PET/CT or PET/MR for attenuation correction.
Interpretation of the CT/MR portion of the study is included in the PET fee and is not separately billable.
Current guidelines and approved indications are maintained by Ontario Health at https://ontariohealth.ca/clinical/pet-scans.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.