G863 – ICHSC haemodialysis
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G863 is a chronic dialysis weekly team fee for patients receiving haemodialysis in an Integrated Community Health Services Centre (ICHSC). A 'team fee' covers the services provided by a team of physicians for a patient over a 7-day period (, ). The code representing the predominant location and modality of dialysis for that week should be claimed. This fee is inclusive of routine assessments by members of the dialysis team.
When to Use
- Use G863 when a patient receives the majority of their haemodialysis treatments within a 7-day period at an Integrated Community Health Services Centre (ICHSC).
- Apply this code when managing chronic dialysis patients where the ICHSC setting is the primary location of care for that specific week.
Common Pitfalls
- Claiming G863 alongside individual visit codes like A007 or A001 for routine dialysis assessments, which are already included in the weekly team fee.
- Submitting G863 when the patient received the majority of their treatments in a different facility type, such as a hospital-based unit (G860/G861) or home setting (G864/G865).
- Billing multiple dialysis team fees within the same 7-day window, violating the rule that only one weekly fee is permitted per patient.
Billing Tips
- Ensure the claim reflects the predominant modality and location for the week; if the patient splits time between settings, only the setting with the highest number of treatments qualifies.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ManagementFee
Diagnostic and Therapeutic Procedures
Claim the code representing the predominant location and modality.
Where 3 or more treatments are rendered per 7-day period at an auxiliary treatment centre, the service comprises the chronic dialysis weekly team fee paid at the full amount, regardless of the number of treatments rendered.
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