All codes
T907
T907 – T907
OHIP Other Code · Schedule of Benefits
When to Use
- Use T907 for the initial consultation of a patient with a confirmed diagnosis of a malignant neoplasm when a comprehensive assessment and management plan are required.
- Select T907 when the patient is referred by another physician specifically for the management of a new cancer diagnosis, distinguishing it from a standard A007 consultation.
Common Pitfalls
- Billing T907 in conjunction with a minor assessment code like A001 on the same day is a common rejection trigger as the consultation fee is intended to be all-inclusive.
- Submitting T907 without a valid referring physician number or failing to document the referral source will result in an automatic claim rejection.
Billing Tips
- Ensure the clinical record explicitly supports the complexity of a malignant neoplasm consultation to withstand potential Ministry audits regarding the necessity of the higher fee code.
Provider Fee$211.15
Specialist Fee$253.26
Effective: April 1, 2025
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