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Consultations

Billing for consultations, including minor, repeat and comprehensive consultations

Criteria:

All of the following criteria must be met:

  • The referring practitioner (i.e., physician, midwife, chiropractor, podiatrist, dentist, optometrist, physical therapist or nurse practitioner) must have examined the patient first and requested a consultation.
  • The referring practitioner makes a request (either verbal or written) for an opinion from the consulting physician.
  • The consulting physician completes a history, examination and review or ordering of diagnostic material. The physician then provides a written opinion with recommendations about treatment to the referring practitioner.  Consultations may include a discussion with the patient and or the referring practitioner.

These fee codes may not be claimed for the following:

Related fee codes:

  • Minor Consultation (03.07A, 03.07AZ)
  • Repeat Consultations (03.07B, 03.07C)
  • Comprehensive Consultations (03.08A, 03.08AZ, 03.08B, 03.08BZ, 03.08M, 03.08C, 03.08CV, 03.08F, 03.08H, 03.08K, 03.09A, 03.09B)

Governing rules:

4.3, 4.4, 4.5, 4.6, 6.6.4, 6.8.1