K041 – Group counselling - additional units
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Group Counselling is counselling rendered to two or more patients with a similar medical condition or situation. It is a patient visit dedicated solely to an educational dialogue with a physician for the purpose of developing awareness of the patient's problems or situation and of modalities for prevention and/or treatment, and to provide advice and information in respect of diagnosis, treatment, health maintenance and prevention. This service is for additional units where any group member has received 3 or more units of any counselling paid under codes K013 and K040 combined per provider per 12 month period. As per :, this service includes specific elements such as performing the appropriate therapy or interaction, making arrangements for related care, discussion with and providing advice to the patient, and providing necessary resources.
When to Use
- Use K041 when a patient has already exhausted the 3-unit limit for K013 or K040 within a 12-month period and continues to require group-based therapeutic intervention.
- Use this code for structured group sessions involving two or more patients with identical chronic conditions, such as diabetes management or smoking cessation, once the initial K040 threshold is met.
Common Pitfalls
- Billing K041 without verifying that the patient has already reached the 3-unit threshold for K013/K040, which leads to automatic rejections.
- Failing to maintain a separate log of all attendees' health numbers, which is a mandatory audit requirement distinct from the individual patient chart.
- Billing K041 on the same day as an office visit (A007) for the same diagnosis, which violates the restriction against concurrent billing of counselling and assessment services.
Billing Tips
- Ensure the claim is submitted under the health number of the specific group member who has the highest cumulative count of prior K013/K040 units to satisfy Ministry submission logic.
- Always document the exact start and end times in the chart, as sessions under 20 minutes are ineligible for K041 and will be downgraded to a standard assessment fee.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Counselling
Psychotherapy, Psychiatric and Counselling Services
The physician must record the start and end time of the service in the patient's permanent medical record or chart (:).
The physician must maintain a separate record (independent of the patient's medical record) of the names and health numbers of all persons in attendance at each group counselling session (:).
Group counselling does not apply to lectures.
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