All codes
T606
T606 – T606
OHIP Other Code · Schedule of Benefits
When to Use
- Use T606 for the initial consultation of a patient referred by another physician for the assessment of a complex medical condition requiring a comprehensive evaluation.
- Apply T606 when the patient has not been seen by your specialty for the specific condition within the preceding 12 months, effectively resetting the consultation eligibility.
- Utilize T606 instead of A007 when the complexity of the clinical presentation necessitates a formal written report back to the referring physician.
Common Pitfalls
- Billing T606 for a patient who has been seen by you or a partner in the same group for the same diagnosis within the last 12 months, which will trigger a rejection for a repeat consultation.
- Submitting T606 without a valid referring physician billing number, as the Ministry requires a formal referral to validate the consultation status.
- Failing to provide a formal written consultation report to the referring physician, which is a mandatory requirement for the T606 fee to be considered valid during an audit.
Billing Tips
- Ensure the referral note is dated prior to the T606 service date to avoid automatic rejection for missing referral documentation.
- If the patient requires follow-up care after the initial T606, switch to the appropriate subsequent visit code (e.g., A005) to avoid audit flags for excessive consultation billing.
Provider Fee$118.45
Specialist Fee$118.45
Effective: February 1, 2011
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