K029 – Insulin therapy support (ITS)
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
ITS is a time-based all-inclusive visit fee per patient per day for the purpose of providing assessment, support and counselling to patients on intensive insulin therapy requiring at least 3 injections per day or using an infusion pump. The service includes any combination of common and specific elements of any insured service listed under “Family Practice & Practice In General” in the “Consultations and Visits” section and, in all cases, includes the same minimum time period requirements described for counselling in the General Preamble . Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements. Maximum 6 units per patient, per physician, per year.
When to Use
- Use K029 when providing comprehensive insulin titration, pump troubleshooting, or intensive diabetes education for patients requiring 3+ injections daily or using an insulin pump.
- Use K029 instead of a standard A007 assessment when the primary focus of the visit is the complex management of intensive insulin therapy rather than a general physical or acute illness.
Common Pitfalls
- Billing K029 on the same day as an A007 or other assessment code will result in a rejection or zero-payment for the K029, as it is an all-inclusive fee.
- Exceeding the annual limit of 6 units per patient per physician will trigger an automatic rejection; ensure you track the cumulative units billed per patient across the fiscal year.
- Failing to document the exact start and end times in the chart is a common audit failure, as K029 is strictly time-based per GP7 and GP55 requirements.
Billing Tips
- If the patient is seen within 14 days of discharge from an acute care hospital, append E080 to K029 to capture the $25.25 premium, as K029 is an eligible service for this add-on.
- Since K029 is a time-based code, ensure your documentation explicitly justifies the duration spent on insulin-specific counselling to satisfy the 'major part thereof' requirement for each 30-minute unit.
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.
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