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K017

K017Periodic health visit - child

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

A periodic health visit (including a primary or secondary school examination) is performed on a patient, after their second birthday, who presents and reveals no apparent acute physical or mental illness. The service must include an intermediate assessment, a level 2 paediatric assessment or a partial assessment focusing on age and gender appropriate history, physical examination, health screening and relevant counselling. As per and , this code is specifically for a child.

When to Use

  • Use K017 for asymptomatic well-child check-ups for patients aged 2 up to and including 15 years old.
  • Use this code for routine school physicals where the patient presents without acute illness or injury.

Common Pitfalls

  • Billing K017 for a patient who has already reached their 16th birthday will result in an automatic rejection; use K013 for patients 16 and older.
  • Claiming K017 on the same day as an acute care visit (e.g., A007) for the same patient is considered double-dipping and will trigger an audit.
  • Exceeding the annual limit for periodic health visits per patient will result in non-payment.

Billing Tips

  • If the child presents with an acute issue during the well-child visit, bill the appropriate assessment code (e.g., A007) instead of K017 to ensure proper compensation for the complexity of the visit.
Provider Fee$49.55

Effective: April 1, 2026

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Assessment

Code Classes

Assessments

Age Restriction

child (a person 2 years to and including 15 years of age)

For definitions and payment rules - see General Preamble .

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