1What Is the A911 OHIP Code?
What is the A911 OHIP Billing Code?
The A911 code is designated for special family and general practice consultations in Ontario under OHIP. This code is used by family physicians and general practitioners when performing extended consultations, ensuring appropriate compensation for the time and expertise provided.
Clinically, such consultations may involve complex history taking, detailed examination, or significant decision-making. Due to time demands, physicians may miss the opportunity to use this code when time spent with a patient extends beyond a typical consultation.
To effectively utilize this code, awareness of the service's time requirements and documentation standards is crucial. Misuse or underuse can result in lost revenue, impacting the practice's financial health.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A912 | Upgrade to 75-min comprehensive tier | Infrequent | Used for extended consultations with at least 75 minutes of direct contact. |
| A905 | Standard FP consultation | Common | Used for regular consultations without a time minimum. |
3Eligibility Requirements
Eligibility Criteria for A911
To bill using the A911 code, you must:
- Be a GP or family physician providing the consultation.
- Spend a minimum of fifty (50) minutes in direct patient contact, excluding any separately billable interventions.
- Ensure that your documentation clearly reflects the duration and nature of services rendered during the consultation.
This code can only be used when the criteria above is met, and should not include time spent on other billable services.
4What Your Clinical Note Must Show
Ensure your documentation comprehensively reflects the consultation process and time spent.
- Duration of contact (at least 50 minutes).
- Objective findings and decisions made.
- Patient's history and treatment plan.
5Weak vs. Strong Note Examples
The strong note explicitly meets the time requirement and details the consultation specifics, whereas the weak note lacks depth and precise information.
Patient seen for long consultation. Discussed issues and provided advice.
Conducted a 50-minute consultation addressing patient's multiple concerns including diabetes management and hypertension control.
Thorough history taken and medication reviewed.
- Discussed lifestyle changes.
- Adjusted medication dosage.
- Arranged follow-up in two weeks.
