All codes
T028
T028 – T028
OHIP Other Code · Schedule of Benefits
When to Use
- Use T028 for the initial consultation of a patient with a suspected or confirmed malignancy when a formal, written report is generated for the referring physician.
- Select T028 instead of A005 when the complexity of the oncological assessment requires a comprehensive review of diagnostic imaging, pathology reports, and treatment planning.
Common Pitfalls
- Billing T028 for a follow-up visit instead of the appropriate subsequent visit code (e.g., A006) will result in a rejection or recovery during audit.
- Failing to include the referring physician's billing number on the claim is a frequent cause for automatic rejection of this consultation code.
Billing Tips
- Ensure the consultation report is dated and sent to the referring physician within the required timeframe to substantiate the T028 claim during a Ministry review.
Provider Fee$258.68
Specialist Fee$258.68
Effective: February 1, 2011
Since Apr 2004, this fee has increased 4.0% vs 13.4% CPI inflation
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