All codes
T370
T370 – T370
OHIP Other Code · Schedule of Benefits
When to Use
- Use T370 when performing a formal consultation for a patient referred by another physician or nurse practitioner for a specific clinical problem.
- Use this code when the consultation results in a written report to the referring provider that includes a comprehensive assessment and a detailed treatment plan.
- Select T370 instead of A007 when the complexity of the patient's condition requires a formal consultative opinion rather than a standard office visit.
Common Pitfalls
- Billing T370 without a valid written referral from a primary care provider or another specialist will result in an automatic rejection.
- Submitting T370 for a patient who has been seen by you for the same condition within the previous 12 months is a common cause for audit recovery.
- Failing to document the specific referral source and the date of the request in the medical record is a frequent reason for claim reversal during Ministry audits.
Billing Tips
- Ensure the referring physician's billing number is included in the claim submission to avoid processing delays.
- If the consultation leads to a procedure on the same day, ensure you are aware of the specific rules regarding the combination of T370 with surgical procedure codes to avoid unbundling errors.
Provider Fee$172.31
Specialist Fee$206.69
Effective: April 1, 2025
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