All codes
T030
T030 – T030
OHIP Other Code · Schedule of Benefits
When to Use
- Use T030 for the initial consultation of a patient referred for a complex assessment of a suspected or confirmed neurological disorder.
- Apply this code when the consultation requires a comprehensive neurological examination and detailed history taking that exceeds the scope of a standard A005 assessment.
Common Pitfalls
- Billing T030 in conjunction with a minor assessment code like A001 or A007 on the same day for the same patient is a common cause for rejection.
- Failing to include a valid referring physician number on the claim will result in an automatic rejection by OHIP.
- Using T030 for a follow-up visit instead of the appropriate subsequent visit code (e.g., A030) will trigger an audit flag for inappropriate billing frequency.
Billing Tips
- Ensure the consultation note clearly justifies the complexity of the neurological assessment to support the higher fee compared to a standard specialist consultation code.
- If the patient requires a second opinion or a new consultation for a different condition within the same year, ensure the referral is distinct and documented to avoid 'duplicate claim' rejections.
Provider Fee$206.97
Specialist Fee$206.97
Effective: February 1, 2011
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