All codes
Q303
Q303 – Q303
OHIP Critical Care Code · Schedule of Benefits
When to Use
- Use Q303 when performing a formal consultation for a patient referred by another physician or nurse practitioner where the patient has not been seen by you for the same condition in the preceding 12 months.
- Apply this code for a comprehensive assessment of a new clinical problem that requires a written report back to the referring provider, distinguishing it from a simple A007 assessment.
Common Pitfalls
- Billing Q303 when the patient has been seen by you or a partner in the same group for the same diagnosis within the last year, which triggers a rejection for a repeat consultation.
- Failing to ensure the referral is documented and valid, as Q303 requires a formal request from a primary care provider or another specialist to be eligible for payment.
- Submitting Q303 for a patient who is already under your active care for the same condition, as this should be billed as a subsequent visit (A005) rather than a consultation.
Billing Tips
- Ensure your clinical note explicitly references the referring physician's name and the date of the referral request to satisfy audit requirements for consultation eligibility.
- If the patient requires a follow-up visit after the initial Q303, switch to the appropriate A-code (e.g., A005) for all subsequent encounters to avoid billing errors.
Provider Fee$83.43
Effective: April 1, 2026
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