K002 – Interviews with relatives or authorized decision maker
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Interviews are not eligible for payment when the information being obtained is part of the history normally included in the consultation or assessment of the patient. The interview must be a booked, separate appointment lasting at least 20 minutes. This service is for interviews with relatives or a person authorized to make a treatment decision on behalf of the patient under the Health Care Consent Act. It applies to situations where medically necessary information cannot be obtained from or given to the patient or guardian, for reasons such as illness or incompetence. The service is claimed using the patient's health number and diagnosis. For detailed time calculation rules, see General Preamble pages - and .
When to Use
- Use K002 when a patient is cognitively impaired or incapacitated and you must book a separate, dedicated 20-minute session with a Power of Attorney to discuss complex care planning that falls outside the scope of a standard assessment.
- Use K002 when coordinating care for a patient with severe psychiatric illness where the patient is unable to provide a reliable history and a separate, lengthy interview with a family member is required to establish a treatment plan.
Common Pitfalls
- Claiming K002 for routine updates or discussions with family that occur during or immediately following a standard office visit (A007/A001), which is considered a constituent element of the visit and is non-billable.
- Failing to document the exact start and end times, which leads to automatic rejection or recovery during audits since K002 requires a minimum of 20 minutes of face-to-face time.
- Billing K002 for obtaining informed consent alone, as the Ministry explicitly excludes interviews conducted for the sole purpose of obtaining consent.
Billing Tips
- Ensure the appointment is booked as a distinct, separate encounter in your EMR to satisfy the requirement that the interview is not part of the patient's routine assessment history.
- If the interview lasts longer than 20 minutes, ensure your documentation clearly reflects the time spent, as K002 is a time-based code that requires strict adherence to the General Preamble time calculation rules.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Interviews
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
The physician must be able to demonstrate that the purpose of the interview is not for the sole purpose of obtaining consent.
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