All codes
T630
T630 – T630
OHIP Other Code · Schedule of Benefits
When to Use
- Use T630 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive history and physical examination.
- Select T630 when managing a patient with a complex hematologic or oncologic condition that does not meet the specific criteria for a more specialized consultation code like A630.
Common Pitfalls
- Billing T630 in conjunction with a subsequent visit code (A631) on the same day is prohibited and will trigger an automatic rejection.
- Failing to include the referring physician's billing number on the claim will result in a rejection, as T630 requires a formal referral to be valid.
Billing Tips
- Ensure the clinical note clearly documents the referral source and the specific oncologic question being addressed to satisfy audit requirements for a consultation.
Provider Fee$75.52
Specialist Fee$90.50
Effective: April 1, 2025
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