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T336

T336T336

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T336 for the initial consultation of a patient referred for a complex surgical or medical assessment that requires a comprehensive evaluation beyond a standard office visit.
  • Apply this code when the clinical complexity necessitates a detailed review of records and a formal written report to the referring physician, distinguishing it from a standard A007 or A005 assessment.

Common Pitfalls

  • Billing T336 for a patient who has been seen by the same physician or a partner in the same group for the same diagnosis within the preceding 12 months, which triggers an automatic rejection.
  • Submitting T336 without a formal, dated referral from a primary care provider or another specialist, as the Ministry requires proof of referral for all consultation codes.

Billing Tips

  • Ensure the clinical note explicitly justifies the complexity of the consultation to support the higher fee compared to a standard assessment code like A007.
Provider Fee$234.90
Specialist Fee$281.90

Effective: February 1, 2011

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