K007 – Individual care
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Individual psychotherapy, which may include narcoanalysis, psychoanalysis, or treatment of sexual dysfunction. Psychotherapy is a form of treatment for mental illness, behavioural maladaptations, and/or other problems assumed to be of an emotional nature, where a physician deliberately establishes a professional relationship with a patient to remove, modify, or retard existing symptoms, or to attenuate or reverse disturbed patterns of behaviour, and promote positive personality growth and development. This service is time-based, billed in units of 1/2 hour or major part thereof. See General Preamble pages to for detailed definitions and time-keeping requirements.
When to Use
- Use K007 for individual psychotherapy sessions lasting at least 20 minutes where the primary focus is modifying maladaptive behaviors or emotional symptoms.
- Use K007 instead of a standard A007 office visit when the encounter is dedicated entirely to therapeutic intervention rather than diagnostic assessment or physical examination.
Common Pitfalls
- Billing K007 for sessions lasting less than 20 minutes, which will be rejected or audited as they do not meet the minimum time requirement for psychotherapy.
- Claiming K007 on the same day as an A007 or other assessment code without documenting distinct, unrelated diagnoses for both services, leading to automatic rejection.
- Failing to explicitly document the start and end times of the psychotherapy session, which is a mandatory requirement for audit compliance under GP7.
Billing Tips
- Ensure your documentation clearly distinguishes the psychotherapy session from a standard medical visit by focusing on the therapeutic process rather than physical findings.
- If you qualify for the Focused Practice Psychotherapy Premium, ensure your billing software is correctly applying the 17% increase to your K007 claims to maximize revenue.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Psychotherapy
Psychotherapy, Psychiatric and Counselling Services
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
Psychotherapy outside hospital and hypnotherapy may not be claimed as such when provided in conjunction with a consultation or other assessments rendered by a physician during the same patient visit unless there are clearly defined different diagnoses for the two services.
Unit means ½ hour or major part thereof - see General Preamble , to for definitions and time-keeping requirements.
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