All codes
T237
T237 – T237
OHIP Other Code · Schedule of Benefits
When to Use
- Use T237 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive evaluation of the disease stage and treatment plan.
- Apply this code when providing a formal specialist consultation for complex oncology cases that exceed the scope of a standard A007 or A005 assessment.
Common Pitfalls
- Billing T237 in conjunction with a subsequent visit code like A007 on the same day is a common rejection trigger; ensure the service meets the criteria for a formal consultation.
- Failing to include a valid referring physician number will result in an automatic rejection, as this code requires a formal referral to be valid under OHIP rules.
Billing Tips
- Ensure the consultation note clearly outlines the complexity of the malignancy and the specific treatment recommendations to justify the higher fee compared to standard assessment codes.
- If the patient is seen for a follow-up related to the same condition, switch to the appropriate follow-up code rather than attempting to re-bill T237.
Provider Fee$195.11
Specialist Fee$195.11
Effective: February 1, 2011
Since Apr 2004, this fee has increased 7.5% vs 13.4% CPI inflation
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.