All codes
P016
P016 – P016
OHIP Plastic Surgery Code · Schedule of Benefits
When to Use
- Use P016 as a mandatory administrative code when billing for the assessment of a patient in a Long-Term Care facility to indicate the visit occurred in that specific setting.
- Apply this code in conjunction with a primary consultation or assessment code (such as A007 or A005) to satisfy the requirement for location-based reporting in institutional settings.
Common Pitfalls
- Billing P016 as a standalone service code will result in an automatic rejection because it carries a $0.00 fee and is strictly a modifier/indicator code.
- Failing to link P016 to the correct primary service code on the same claim will lead to a 'missing service code' error or audit flag for improper billing structure.
Billing Tips
- Ensure your billing software is configured to automatically append P016 when the location code for a Long-Term Care facility is selected to prevent manual entry errors.
Provider Fee$0.00
Anaesthetist Fee$15.96
Non-Anaesthetist Fee$15.96
Effective: April 1, 2026
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