All codes
T501
T501 – T501
OHIP Other Code · Schedule of Benefits
When to Use
- Use T501 for the initial consultation of a patient referred for a specific diagnostic assessment or specialized management plan that does not meet the criteria for a full A005 or A007 consultation.
- Apply T501 when providing a focused specialist opinion on a patient who has been previously seen by your practice for a different condition, provided the criteria for a consultation are met.
Common Pitfalls
- Billing T501 in conjunction with a minor assessment code like A001 on the same day for the same patient will trigger an automatic rejection.
- Failing to ensure a formal written referral is on file, as T501 is strictly a consultation code and requires a referring physician or nurse practitioner.
Billing Tips
- Ensure your documentation clearly distinguishes the T501 consultation from a subsequent assessment (K030) to avoid claims being downgraded during a post-payment audit.
Provider Fee$57.09
Specialist Fee$68.64
Effective: February 1, 2011
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