K736 – CritiCall telephone consultation - Referring physician
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A CritiCall telephone consultation is a service where the referring physician, or nurse practitioner in light of his/her professional knowledge of a patient, requests the opinion of a physician (the "consultant physician”) by telephone and where the telephone consultation has been arranged by CritiCall Ontario.
Definition/Required elements of service – Referring physician/Nurse practitioner
The referring physician/nurse practitioner initiates the telephone consultation through CritiCall for the purpose of discussing the management of the patient and/or transfer of the patient to the consultant physician.
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/nurse practitioner to obtain the advice of the consultant physician. This service is for use by physicians on duty in an emergency department or a hospital urgent care clinic.
When to Use
- Use K736 when you are the referring physician in an emergency department or urgent care clinic and you initiate a call through CritiCall to secure a specialist consultation or patient transfer.
- Use K736 specifically for the referring side of the CritiCall interaction, ensuring you do not use K732, which is restricted for this specific service path.
Common Pitfalls
- Billing K732 instead of K736 is a common error; K732 is strictly prohibited when the consultation is facilitated through the CritiCall system.
- Claiming K736 for telephone consultations that were not formally arranged or logged through the CritiCall Ontario system will result in audit recovery.
Billing Tips
- K736 is eligible for payment in addition to other visits or procedures performed on the same patient on the same day, so ensure you bill both the clinical service and the K736 code.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Consultations
The Definition/Required elements of service and Payment rules for consultations in the General Preamble are not applicable to CritiCall 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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