A912 OHIP Billing Code: Maximize Reimbursements with Comprehensive Consultations

The A912 code under OHIP is designated for comprehensive consultations provided by family and general practice physicians. These consultations require a minimum of 75 minutes of direct patient contact and include all elements expected in a thorough medical consultation. This code ensures that the time and expertise required to address complex patient needs are adequately compensated. Given the specific requirements, it's crucial that physicians meet the full criteria to avoid underbilling or claim denials.

Family and general practice physicians often miss out on billing A912 due to misconceptions about the required consultation length or failing to document the start and stop times explicitly. Understanding the precise requirements and thoroughly documenting the consultation are key to utilizing this code efficiently.

To bill the A912 code, the consultation must be provided by a GP or FP and must last at least 75 minutes of direct contact with the patient. This time is exclusive of any other separately billable interventions provided during the same visit. Accurate recording of the start and stop times of the consultation in the patient's permanent medical record is mandatory; otherwise, the service may be adjusted to a lower fee. No other consultation, assessment, visit, or counselling service is billable to the same patient on the same day by the same physician.