All codes
T495
T495 – T495
OHIP Other Code · Schedule of Benefits
When to Use
- Use T495 for the initial assessment and management of a patient with a confirmed diagnosis of acute or chronic leukemia.
- Apply this code when performing a comprehensive consultation for a patient referred specifically for the evaluation of a hematologic malignancy.
Common Pitfalls
- Do not bill T495 in conjunction with a general internal medicine consultation code (A130) for the same patient encounter, as this constitutes unbundling.
- Avoid using T495 for routine follow-up visits; these must be billed using the appropriate subsequent visit codes (C002 or C003) to avoid rejection for duplicate service types.
Billing Tips
- Ensure the referral note explicitly mentions the suspicion or diagnosis of leukemia to support the medical necessity of this specific specialist consultation fee.
Provider Fee$185.86
Specialist Fee$185.86
Effective: April 1, 2025
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