All codes
T375
T375 – T375
OHIP Other Code · Schedule of Benefits
When to Use
- Use T375 for the initial consultation of a patient with a confirmed diagnosis of malignant neoplasm when the service is provided by a specialist in medical oncology or radiation oncology.
- Apply this code when performing a comprehensive assessment and treatment planning for a new oncology patient who has not been seen by your specific specialty group for this diagnosis in the preceding 12 months.
Common Pitfalls
- Billing T375 alongside a subsequent visit code like A375 for the same patient on the same day will result in an automatic rejection.
- Submitting T375 without the required diagnostic code for the specific malignancy will trigger a rejection, as the claim must be linked to a valid ICD-9 code for cancer.
Billing Tips
- Ensure the referral source is clearly documented and valid, as T375 requires a formal referral from a primary care physician or another specialist to be eligible for payment.
- If the patient requires a multidisciplinary case conference following the initial consultation, bill the appropriate conference code separately, as T375 only covers the initial assessment and planning.
Provider Fee$375.08
Specialist Fee$375.08
Effective: April 1, 2025
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.