G865 – Home haemodialysis
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
G865 is a chronic dialysis weekly team fee for patients undergoing haemodialysis at home. The note on page : specifies to claim the code representing the predominant location and modality for the 7-day period. This fee covers the collective services provided by the healthcare team for managing the patient's chronic dialysis.
When to Use
- Use G865 when the patient is established on a home haemodialysis program and the majority of their dialysis sessions within a 7-day period occur in the home setting.
- Use G865 to capture the weekly management fee for a patient who is self-administering haemodialysis at home, rather than using facility-based codes like G860 or G861.
Common Pitfalls
- Billing G865 for a patient who spent the majority of the week receiving in-centre dialysis, which violates the requirement to claim based on the predominant location.
- Submitting G865 in the same 7-day period as other dialysis modality codes like G862 or G863, which will trigger a rejection for duplicate or conflicting service claims.
Billing Tips
- Ensure your billing cycle aligns with a 7-day window to accurately determine the predominant modality, as G865 is a weekly team fee rather than a per-treatment fee.
Effective: April 1, 2026
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
ManagementFee
Diagnostic and Therapeutic Procedures
1. Claim the code representing the predominant location and modality.
2. 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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