All codes
T702
T702 – T702
OHIP Other Code · Schedule of Benefits
When to Use
- Use T702 for the initial consultation of a patient referred for a complex assessment of a chronic pain syndrome or refractory pain condition.
- Apply this code when the patient has been referred by another physician specifically for a comprehensive evaluation that exceeds the scope of a standard A005 or A007 consultation.
Common Pitfalls
- Billing T702 when the referral is for a routine follow-up or a minor procedure, which should instead be billed under standard office visit codes.
- Submitting T702 without a valid referring physician number or failing to meet the requirement for a formal written referral from a primary care provider or another specialist.
- Attempting to bill T702 in conjunction with a minor assessment code on the same day, which will trigger an automatic rejection for unbundling.
Billing Tips
- Ensure the clinical note explicitly justifies the complexity of the consultation to support the higher fee compared to standard consultation codes.
- Verify that the referral request is documented in the patient chart prior to the visit to satisfy OHIP audit requirements for specialist consultations.
Provider Fee$205.00
Specialist Fee$246.00
Effective: February 1, 2011
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