All codes
T211
T211 – T211
OHIP Other Code · Schedule of Benefits
When to Use
- Use T211 for the initial consultation of a patient referred by another physician for a specific diagnostic or therapeutic problem within the specialty.
- Use T211 when the patient has not been seen by your practice for the specific condition within the preceding 12 months, effectively resetting the consultation eligibility.
Common Pitfalls
- Billing T211 when the patient has been seen by you or a partner in the same group for the same diagnosis within the last 12 months, which should be billed as an A007 assessment instead.
- Submitting T211 without a valid referring physician number, which will trigger an automatic rejection from the Ministry.
Billing Tips
- Ensure the referral note is dated prior to the T211 service date to avoid audit clawbacks regarding the validity of the consultation request.
Provider Fee$75.00
Specialist Fee$75.00
Effective: February 1, 2011
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