All codes
T235
T235 – T235
OHIP Other Code · Schedule of Benefits
When to Use
- Use T235 for a formal consultation requested by a referring physician for a patient with a complex hematological or oncological condition.
- Apply this code when the patient has not been seen by your practice for the specific condition within the preceding 12 months, satisfying the requirements for a new consultation.
Common Pitfalls
- Billing T235 when the patient has been seen for the same diagnosis by the same physician or group within the last 12 months, which should be billed as a repeat visit (A035) instead.
- Failing to include a valid referring physician number on the claim, which will result in an automatic rejection by the Ministry.
Billing Tips
- Ensure the consultation request is documented in the patient's chart with the referring physician's name and the specific clinical question to support the T235 claim during an audit.
Provider Fee$390.23
Specialist Fee$390.23
Effective: February 1, 2011
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