H313 – Rehabilitation counselling
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Rehabilitation counselling is a service for one or more persons, rendered for the purpose of developing an awareness of the modalities for treatment of the patient and/or his or her prognosis. As a counselling service, it includes the specific elements outlined in the General Preamble (), such as performing the therapy, making arrangements for related care, discussion with the patient, and monitoring until the next service. The service is time-based, where one unit equals a 1/2 hour or major part thereof. For detailed time unit calculation rules, refer to .
When to Use
- Use H313 for structured rehabilitation planning sessions with patients recovering from stroke, major trauma, or complex physical disabilities where the focus is on prognosis and treatment modalities.
- Apply this code when coordinating multi-disciplinary care plans that require significant time explaining the patient's long-term rehabilitation trajectory, distinct from routine follow-up visits.
- Select H313 when providing intensive education to family members or caregivers regarding the patient's specific rehabilitation requirements and home-care arrangements.
Common Pitfalls
- Billing H313 for sessions lasting less than 20 minutes will result in rejection or audit recovery; these must be billed as standard office visits (e.g., A007).
- Failing to explicitly document the start and end times in the medical record is the most frequent cause of claim reversal during Ministry audits.
- Confusing H313 with K013 or K033; ensure the service is specifically focused on rehabilitation modalities and prognosis rather than general psychotherapy or chronic disease management.
Billing Tips
- Since H313 is an exception to the same-day billing restriction, you may bill it alongside an A007 or other assessment code if the rehabilitation counselling is a distinct service from the medical assessment.
- Calculate units strictly by the 30-minute block; a 45-minute session qualifies for two units (the second unit being a 'major part' of the second 30-minute block).
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Psychotherapy, Psychiatric and Counselling Services, Hospital and Institutional Consultations and Assessments
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
Unit means 1/2 hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
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