All codes
T210
T210 – T210
OHIP Other Code · Schedule of Benefits
When to Use
- Use T210 for the initial consultation of a patient referred for a complex surgical or medical assessment requiring a comprehensive evaluation.
- Apply this code when the patient has not been seen by your specialty for the current condition within the previous 12 months, meeting the criteria for a new consultation.
- Select T210 when the referral request necessitates a formal written report back to the referring physician detailing the assessment and management plan.
Common Pitfalls
- Billing T210 when the patient has been seen by another physician in the same group practice for the same diagnosis within the last 12 months, which triggers a rejection for a repeat consultation.
- Submitting T210 without a valid referring physician number or failing to document the referral source, which leads to automatic claim rejection.
- Attempting to bill T210 in conjunction with a minor procedure code that is considered inclusive of the consultation fee, resulting in a payment adjustment.
Billing Tips
- Ensure the referral is documented in the chart with the referring physician's name and billing number to satisfy audit requirements for consultation eligibility.
- If the patient requires a follow-up visit for the same condition, switch to the appropriate follow-up code (e.g., A005) rather than attempting to bill T210 again.
Provider Fee$208.00
Specialist Fee$208.00
Effective: February 1, 2011
Since Jan 2004, this fee has increased 0.0% vs 14.3% CPI inflation
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