K020 – Group psychotherapy - 3 people
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Payable per member for group psychotherapy involving 3 people. Psychotherapy is defined as a form of treatment for mental illness, behavioural maladaptations, and/or other problems that are assumed to be of an emotional nature, where a physician deliberately establishes a professional relationship with a patient with the purpose of removing, modifying or retarding existing symptoms, or attenuating or reversing disturbed patterns of behaviour, and of promoting positive personality growth and development. This service includes narcoanalysis, psychoanalysis, or treatment of sexual dysfunction. Refer to the General Preamble (-) for complete definitions, time-keeping, and billing requirements.
When to Use
- Use K020 when facilitating a structured psychotherapy session with exactly three patients present simultaneously, where the focus is on modifying maladaptive behaviors or symptoms.
- Use K020 for group-based treatment of sexual dysfunction or psychoanalysis when the group size is limited to three participants.
Common Pitfalls
- Billing K020 on the same day as a consultation or assessment (A007, A008) for the same patient without distinct, unrelated diagnoses will trigger an automatic rejection.
- Failing to document the exact start and end times for each individual participant in their respective charts is a frequent cause of audit recovery.
- Billing K020 for a group of four or more participants is incorrect; K020 is specific to a group of three, whereas other codes apply to different group sizes.
Billing Tips
- Ensure the session duration meets the minimum threshold for psychotherapy, as sessions under 20 minutes are considered standard assessments and are ineligible for K020.
- If the session exceeds six hours (12 units), append K010 for each additional 30-minute block to maximize reimbursement for extended group therapy.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Service
Psychotherapy, Psychiatric and Counselling Services
The physician must record the start and end time of the service in the patient's permanent medical record.
Group - per member - first 12 units per day.
Includes narcoanalysis or psychoanalysis or treatment of sexual dysfunction - see General Preamble .
Unit means ½ hour or major part thereof - see General Preamble , to for definitions and time-keeping requirements.
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