K004 – Family psychotherapy
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Family psychotherapy is a form of treatment for mental illness, behavioural maladaptations, and/or other problems of an emotional nature. It is rendered to a patient in the presence of two or more family members at the same time. This service includes narcoanalysis, psychoanalysis, or treatment of sexual dysfunction. It is a time-based service, with a unit defined as ½ hour or a major part thereof. The service includes all specific elements of psychotherapy as defined in the Schedule of Benefits (see ), such as performing the therapy, making arrangements for related care, providing advice, and monitoring the patient's condition.
When to Use
- Use K004 when conducting a structured psychotherapy session involving the patient and at least two other family members simultaneously, as opposed to K005 which is for individual psychotherapy.
- Use K004 for the treatment of sexual dysfunction when the partner is present and actively participating in the therapeutic process.
- Use K004 when addressing family dynamics or behavioral maladaptations that require the active presence of multiple family members to achieve clinical goals.
Common Pitfalls
- Billing K004 for a standard family meeting or case conference that lacks the specific elements of psychotherapy defined in GP54.
- Failing to document the start and end times, which leads to automatic rejection or recovery during an audit as it is a time-based service.
- Attempting to bill K004 on the same day as an A007 or A001 assessment for the same patient without a distinct, unrelated diagnosis, which triggers a billing conflict.
Billing Tips
- Ensure the medical record explicitly lists the names of the family members present, as the presence of at least two family members is a mandatory requirement for this code.
- If you qualify for the Focused Practice Psychotherapy Premium, ensure your billings are correctly categorized to trigger the 17% increase, as it is not automatically applied to all physicians.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Psychotherapy, Psychiatric and Counselling Services
The physician must record the start and end time of the service in the patient's permanent medical record.
Includes narcoanalysis or psychoanalysis or treatment of sexual dysfunction.
Unit means ½ hour or major part thereof - see General Preamble , to for definitions and time-keeping requirements.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.