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T639

T639T639

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T639 for the initial consultation of a patient referred for a specific psychiatric assessment when the criteria for a formal K013 or K015 are not met.
  • Apply this code when providing a comprehensive psychiatric evaluation that exceeds the scope of a standard A007 or A005 office visit.

Common Pitfalls

  • Billing T639 in conjunction with a K013 or K015 on the same day will trigger an automatic rejection for duplicate service.
  • Failing to document the referral source or the specific psychiatric nature of the assessment often leads to audit recovery during OHIP reviews.

Billing Tips

  • Ensure the clinical note explicitly justifies the complexity of the assessment to differentiate it from a standard general practice consultation code like A007.
Provider Fee$67.38
Specialist Fee$67.38

Effective: February 1, 2011

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