All codes
T667
T667 – T667
OHIP Other Code · Schedule of Benefits
When to Use
- Use T667 for the initial assessment of a patient requiring a formal consultation for a specific medical condition when a written report is provided to the referring physician.
- Select T667 when the service meets the criteria for a consultation but does not qualify for the higher complexity requirements of a specific specialty-based consultation code.
- Apply T667 when a patient is referred by another physician or nurse practitioner for a second opinion or management advice on a non-acute, non-emergency clinical issue.
Common Pitfalls
- Billing T667 on the same day as a minor procedure or another visit code for the same patient often leads to automatic rejection or audit flags for unbundling.
- Submitting T667 without a formal, dated, and signed referral request from a primary care provider or another specialist will result in a claim rejection.
- Using T667 for routine follow-up visits instead of the appropriate subsequent visit code (e.g., A007) is a common cause of recovery audits.
Billing Tips
- Ensure the referral source is clearly documented in the claim submission to satisfy the requirement for a valid consultation request.
- Verify that the consultation report is sent to the referring physician promptly, as this is a mandatory requirement for the validity of the T667 fee.
Provider Fee$48.45
Specialist Fee$48.45
Effective: April 1, 2025
Since Jan 2004, this fee has increased 28.0% vs 58.2% CPI inflation
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