In an effort to stop the spread of COVID-19, OHIP is extending and enhancing existing temporary physician funding initiatives. Amended March 14th, 2021, the Schedule of Benefits for Physician Services includes the following changes:
K Codes Extended
Temporary virtual care fee codes K080, K081, K082, and K083 have been extended until September 30th, 2021. These codes include assessments of, counseling to, or advice and information provided to insured patients by telephone or video. For details on changes to refer to OHIP’s bulletin.
Fee Code | Description | Payment |
K080 | Minor assessment of a patient by telephone or video, or advice or information by telephone or video to a patient’s representative regarding health maintenance, diagnosis, treatment and/or prognosis | $23.75 |
K081 |
|
$36.85 |
K082 | Psychotherapy, psychiatric or primary mental health care, counseling, or interview by telephone or video per unit (‘unit’ means half-hour or major part thereof) per unit | $67.75 |
K083 | Specialist consultation or visit by telephone or video payable in increments of | $5.00 per increment |
Palliative care services provided by phone or video between March 14th, 2021 and September 30th, 2021 are eligible for fee codes K092, K093, K094, and K095
Fee Code | Description | Payment |
K092 | Virtual Palliative Care Consultation-Telephone. Minimum of 50 minutes with the patient and/or patient’s representative/family in consultation required | $159.20 |
K093 | Virtual Palliative Care Consultation-Video. Minimum of 50 minutes with the patient and/or patient’s representative/family in consultation required | $159.20 |
K094 | Virtual Palliative Care Support-Telephone. Payable in increments of ½ hour (or major part thereof) | $72.15 |
K095 | Virtual Palliative Care Support-Video. Payable in increments of ½ hour (or major part thereof) | $72.15 |
System changes are scheduled for May 2021 so wait for the INFOBulletin before submitting claims for these codes.
These changes will provide patients continued access to the health care they need through COVID-19 and the roll out of the vaccine. If you have questions about these updates, please get in touch.
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