K730 – Physician to physician telephone consultation - Referring physician
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A physician to physician telephone consultation is a service where the referring physician or nurse practitioner, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician") by telephone who is competent to give advice in the particular field because of the complexity, seriousness, or obscurity of the case. This service is only eligible for payment if the consultant physician has provided an opinion and/or recommendations for patient treatment and/or management. For the purpose of this service, “relevant data” include family/patient history, history of the presenting complaint, laboratory and diagnostic tests, where indicated and feasible in the circumstances. Definition/Required elements of service – Referring physician/Nurse Practitioner The referring physician or nurse practitioner initiates the telephone consultation with the intention of continuing the care, treatment and management of the patient. In addition to the Constituent and Common Elements of Insured Services described in the General Preamble of this Schedule, this service includes the transmission of relevant data to the consultant physician and all other services rendered by the referring physician or nurse practitioner to obtain the advice of the consultant physician.
When to Use
- Use K730 when you initiate a call to a specialist to discuss a complex management plan for a patient you are actively treating, rather than formally referring the patient for a new consultation.
- Use K730 when you require urgent clinical guidance on a patient's obscure diagnosis to avoid an unnecessary emergency department visit or hospital admission.
Common Pitfalls
- Billing K730 when the conversation is merely administrative or involves scheduling, as the code requires the transmission of relevant clinical data and the receipt of management advice.
- Failing to document the name of the consultant physician, which is a mandatory audit requirement for this specific code.
Billing Tips
- You may bill K730 in addition to a same-day office visit (A007) or counselling code (K013), provided the telephone consultation is a distinct clinical event.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Virtual Care Services
The medical record must document the transmission of relevant data to the consultant physician.
The Definition/Required elements of service and payment rules for consultations in the General Preamble are not applicable to physician to physician telephone consultations.
This service is eligible for payment in addition to visits or other services provided to the same patient on the same day by the same referring physician.
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