All codes
Q204
Q204 – Q204
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q204 as the mandatory administrative code when billing for the completion of a Third Party Medical Certificate (e.g., insurance forms or employer notes) where the patient is responsible for the fee.
- Apply Q204 in conjunction with the appropriate service code for the assessment required to complete the document, ensuring the patient is informed of the non-insured status.
Common Pitfalls
- Billing Q204 for services covered by OHIP, such as standard medical reports requested by the Ministry or WSIB, which will result in an automatic rejection.
- Failing to link the assessment code to the Q204 administrative fee, which can lead to confusion regarding the total amount billed to the patient.
Billing Tips
- Ensure the patient is billed directly for the Q204 service, as this is a non-insured benefit and cannot be submitted to the Ministry for payment.
Provider Fee$0.00
Effective: August 1, 2024
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