K023 – Palliative care support
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Palliative care support is a time-based service payable for providing pain and symptom management, emotional support and counselling to patients receiving palliative care. Palliative care is defined as care provided to a terminally ill patient in the final year of life where the decision has been made that there will be no aggressive treatment of the underlying disease and care is to be directed to maintaining the comfort of the patient until death occurs. This is a time-based service where the unit is ½ hour or major part thereof.
When to Use
- Use K023 for dedicated sessions focused on complex symptom management or end-of-life counseling for patients with a terminal prognosis, rather than routine physical examinations.
- Bill K023 when providing extended support to a patient or family member to discuss goals of care or advanced directives, provided the patient meets the terminal illness criteria.
Common Pitfalls
- Billing K023 on the same day as a standard office visit (A007) or chronic disease management code (K030) will result in a rejection, as K023 is exclusive of most other 'Family Practice' visit codes.
- Failing to document exact start and stop times in the chart is the most common reason for OHIP to claw back the fee to a lower-valued assessment code during an audit.
- Attempting to bill K023 for patients who do not meet the strict 'final year of life' definition or who are still pursuing aggressive, curative treatment for their underlying disease.
Billing Tips
- You may bill K023 in conjunction with A945/C945 (Palliative Care Case Management), as these are the only exceptions to the exclusivity rule for Family Practice visit codes.
- Ensure the chart note explicitly justifies the time spent on palliative support, as the Ministry frequently reviews these claims to ensure the service was not a standard assessment.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Assessments, Psychotherapy, Psychiatric and Counselling Services
Start and stop times must be recorded in the patient's permanent medical record or the service will be adjusted to a lesser paying fee.
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