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K006

K006Individual care

OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits

Hypnotherapy is a form of treatment that has the same goals as psychotherapy but is rendered with the patient under hypnosis. In addition to the common elements, hypnotherapy includes the following specific elements as per : A. Performing the appropriate therapy or interaction (described below) with the patient(s) which may include the appropriate inquires (including obtaining a patient history, and a brief physical examination) carried out in order to arrive at an opinion as to the nature of the patient's condition (whether such inquiry takes place before, during or after the encounter during which the therapy or other interaction takes place); any appropriate procedure(s), related service(s), and/or follow-up care. B. Performing any procedure(s) during the same encounter as the therapy or other interaction unless the procedure(s) is(are) separately listed in the Schedule and an amount is payable for the procedure in conjunction with the therapy or interaction. C. Making arrangements for any related assessments, procedures, or therapy. D. Making arrangements for follow-up care. E. Discussion with, and providing advice and information, including prescribing therapy to the patient or the patient's representative, whether by telephone or otherwise, on matters related to: a. the service; and b. in circumstances in which it would be professionally appropriate that results can be reported upon prior to any further patient visit, the results of related procedure(s) and/or assessment(s). F. When medically indicated, monitoring the condition of the patient and intervening, until the next insured service is rendered. G. Providing premises, equipment, supplies, and personnel for the specific elements of the service.

When to Use

  • Use K006 for individual hypnotherapy sessions lasting at least 20 minutes when the primary therapeutic modality is hypnosis.
  • Use K006 when providing individual psychotherapy or counselling that does not meet the specific criteria for K007 (group) or K013 (family).

Common Pitfalls

  • Billing K006 on the same day as a consultation or assessment (A-codes) without documenting distinct, unrelated diagnoses, which triggers automatic rejection.
  • Failing to document exact start and end times in the chart, which is a mandatory requirement for all time-based K-codes and a frequent audit failure point.
  • Claiming K006 for sessions lasting less than 20 minutes; these must be billed as a standard office visit (A007) instead.

Billing Tips

  • If you are registered for the Focused Practice Psychotherapy Premium, ensure your billing software is configured to automatically apply the 17% premium to K006 claims.
  • Always ensure the total duration of the encounter is clearly recorded to justify the K-code over a standard visit code.
Provider Fee$80.00

Effective: April 1, 2026

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Other

Code Classes

Psychotherapy, Psychiatric and Counselling Services

If the service is based upon the number of “units” of service rendered, the physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.

* May not be claimed in conjunction with delivery as the service is included in the obstetrical fees.

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