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T654

T654T654

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T654 for the initial assessment and management of a patient presenting with a specific minor surgical or procedural condition that does not qualify for a full consultation fee.
  • Apply this code when providing a focused assessment for a patient referred for a specific procedure where a full consultation (A005 or similar) is not clinically indicated or required by the referral.

Common Pitfalls

  • Billing T654 in conjunction with a major surgical procedure code on the same day is frequently rejected; ensure the assessment is distinct and not part of the global surgical fee.
  • Attempting to bill T654 for a routine follow-up visit is incorrect, as follow-ups should be billed using the appropriate minor assessment code (e.g., K013 or A007) depending on the specialty.

Billing Tips

  • Ensure the clinical record clearly distinguishes the T654 assessment from any subsequent procedural work to avoid 'included in fee' audit flags.
Provider Fee$31.36
Specialist Fee$39.21

Effective: April 1, 2025

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