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T220

T220T220

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T220 for the initial consultation of a patient referred for a specific psychiatric assessment when the consultation exceeds the scope of a standard A005 assessment.
  • Apply T220 when providing a formal psychiatric consultation requested by another physician, provided the patient has not been seen by you for the same condition within the previous 12 months.

Common Pitfalls

  • Billing T220 for follow-up visits, which must be billed using subsequent visit codes like A007 instead of a consultation code.
  • Submitting T220 without a valid referring physician number, as this code strictly requires a formal referral to be eligible for payment.
  • Attempting to bill T220 on the same day as a psychotherapy code like K007, which will trigger an automatic rejection due to service duplication.

Billing Tips

  • Ensure the referral is documented in the patient's chart with the referring physician's name and billing number to satisfy audit requirements for consultation eligibility.
  • If the consultation results in a decision to provide ongoing psychotherapy, ensure subsequent sessions are billed under the appropriate K-code series rather than repeating the T220.
Provider Fee$96.58
Specialist Fee$96.58

Effective: February 1, 2011

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