K025 – Group psychotherapy - 6 to 12 people
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Group psychotherapy for a group of 6 to 12 people, billed per member. 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 is calculated in time units of 30-minute increments, with a minimum of 20 minutes of direct contact required for the first unit. Refer to the General Preamble (-) for detailed definitions and time-keeping requirements.
When to Use
- Use K025 when facilitating a structured psychotherapy session for a group of 6 to 12 patients where the primary goal is the modification of emotional symptoms or maladaptive behaviors.
- Choose K025 over K024 when the group size exceeds 5 participants, as K024 is strictly limited to groups of 2 to 5 members.
Common Pitfalls
- Billing K025 on the same day as a consultation or assessment for the same patient will trigger an automatic rejection unless you document two distinct, unrelated diagnoses.
- Failing to record the exact start and end times in each individual patient's chart is a frequent cause of audit recovery, as the 30-minute unit requirement is strictly time-based.
- Claiming K025 for groups smaller than 6 members is a billing error; ensure your attendance records confirm at least 6 patients were present to justify the code.
Billing Tips
- Ensure your documentation explicitly reflects the 'deliberate professional relationship' and the specific therapeutic interventions used, as per the General Preamble requirements for psychotherapy.
- If you qualify for the Focused Practice Psychotherapy Premium, ensure your billing software is correctly applying the 17% increase to K025, as this is not always automatic for all group codes.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
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.
Unit means ½ hour or major part thereof - see General Preamble , to for definitions and time-keeping requirements.
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