All codes
T666
T666 – T666
OHIP Other Code · Schedule of Benefits
When to Use
- Use T666 when performing a comprehensive assessment of a patient with a complex chronic condition that requires a multidisciplinary care plan.
- Apply this code instead of A007 when the complexity of the clinical encounter exceeds the scope of a standard intermediate assessment.
Common Pitfalls
- Billing T666 on the same day as a K030 or K031 will trigger an automatic rejection due to overlapping service definitions.
- Submitting T666 without documenting the specific time spent or the complexity of the decision-making process often leads to recovery during post-payment audits.
Billing Tips
- Ensure that the clinical note explicitly justifies the higher complexity of T666 compared to a standard office visit code to withstand Ministry review.
Provider Fee$101.25
Specialist Fee$101.25
Effective: February 1, 2011
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