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OHIP Billing Codes Sheet for General / Family Practitioners

Courtney Marie L.
May. 5, 2017
3-minute read
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For Ontario GPs and family practitioners that manage their own billing, knowing which fee code to use can be a pain. They have more than enough work to do already, and the added complexity of submitting claims to OHIP doesn't help. To help save time, we've put together a short list of the most common OHIP fee codes for family practice & practice in general. We hope this is a useful resource and lets you spend less time going through the massive fee schedule.

Click here for a printable PDF version »

 

Consultations & Assessments

A005 Consultation C005 Consultation (in-patient) A911 Special family and general practice consultation C911 Special family and general practice consultation (in-patient) A912 Comprehensive family and general practice consultation C912 Comprehensive family and general practice consultation (in-patient) A945 Special palliative care consultation C945 Special palliative care consultation (in-patient) A905 Limited consultation C905 Limited consultation (in-patient) A006 Repeat consultation C006 Repeat consultation (in-patient) A003 General assessment C003 General assessment (in-patient) A004 General re-assessment C004 General re-assessment (in-patient) A007 Intermediate assessment or well baby care

Subsequent Visits

C002 First 5 weeks C007 Sixth to thirteenth week inclusive (maximum 3 per patient per week) C009 After thirteenth week (maximum 6 per patient per month)

Periodic Health Visits

K017 Child K130 Adolescent K131 Adult age 18 to 64 inclusive K132 Adult 65 years of age and older

Counselling and Meetings

K002 Family meeting, caregiver interview K005 Primary mental health care – Individual care K007 Psychotherapy - Individual care K013 Counselling - Individual care K014 Counselling for transplant recipients, donors or families of recipients and donors K015 Counselling of relatives - on behalf of catastrophically or terminally ill patient K032 Specific neurocognitive assessment K040 Group counselling K121 Hospital in-patient case conference

Forms

K035 Mandatory reporting of medical condition to the Ontario Ministry of Transportation K038 Completion of Long-Term Care health report form K070 Home ca re application K623 Form 1 - Application for psychiatric assessment C771 Certification of death C777 Intermediate assessment - Pronouncement of death

Telephone & e-Consultations

K730 Physician to physician telephone consultation - Referring physician K731 Physician to physician telephone consultation - Consultant physician K732 CritiCall telephone consultation - Referring physician K738 Physician to physician e-consultation – Referring physician

Want to maximize your earnings? New to Ontario Billing?

Check out our Ultimate OHIP Billing Guide that takes you through every step for billing successfully in Ontario.


  This article offers general information only and is not intended as legal, financial or other professional advice. A professional advisor should be consulted regarding your specific situation. While information presented is believed to be factual and current, its accuracy is not guaranteed and it should not be regarded as a complete analysis of the subjects discussed. All expressions of opinion reflect the judgment of the author(s) as of the date of publication and are subject to change. No endorsement of any third parties or their advice, opinions, information, products or services is expressly given or implied by RBC Ventures Inc. or its affiliates.  
   

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Courtney Marie L
Writer and editor with a demonstrated history of working in the Canadian healthcare sector and the publishing industry. Skilled in writing, editing, proofreading, Spanish to English translation, and teaching English as a second language. Strong communications professional with a Bachelor of Arts in Geography and Political Science from the University of Manitoba.
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