All codes
T580
T580 – T580
OHIP Other Code · Schedule of Benefits
When to Use
- Use T580 for the initial consultation of a patient referred for a specific psychiatric assessment when the consultation does not meet the criteria for a more comprehensive psychiatric assessment code like A195.
- Apply T580 when providing a formal psychiatric consultation for a patient already under your care for a different condition, provided the referral meets the formal requirements for a consultation.
- Use T580 for a one-time psychiatric evaluation requested by another physician to provide an opinion on diagnosis or management plan.
Common Pitfalls
- Billing T580 for a follow-up visit instead of a consultation; follow-up visits must be billed using the appropriate psychiatric follow-up codes.
- Failing to ensure a formal written referral from another physician is on file, as T580 is strictly a consultation code and requires a referring provider.
- Attempting to bill T580 on the same day as a psychotherapy code like K007, which is generally disallowed as the consultation fee is intended to cover the assessment and initial management plan.
Billing Tips
- Ensure the referring physician's billing number is included in the claim to avoid automatic rejection for missing referral information.
- If the consultation results in a decision to assume ongoing care, subsequent visits must transition to follow-up codes rather than repeated T580 billings.
Provider Fee$55.10
Specialist Fee$66.35
Effective: February 1, 2011
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