K055 – Application for Special Diet Allowance
OHIP Consultation & Visit Premium Codes Code — MCSS ONTARIO DISABILITY SUPPORT PROGRAM (ODSP) · Schedule of Benefits
The service K055 provides payment for the completion of the Application for Special Diet Allowance form for an ODSP recipient. According to the information on , this service is not an 'insured service' under the Health Insurance Act. It is paid by the Ministry of Health, which acts as a paying agent for the Ministry of Children, Community and Social Services (MCCSS).
When to Use
- Use K055 when completing the official ODSP Special Diet Allowance form for a patient requiring a medically necessary diet for a listed condition.
- Use this code specifically for the initial application or renewal of the special diet allowance, distinct from the general medical report required for K050.
Common Pitfalls
- Billing K055 alongside an office visit code (A007) for the same date is a common rejection; this service is intended to be billed as a standalone administrative procedure.
- Submitting K055 for patients who are not currently active ODSP recipients will result in a rejection, as the Ministry verifies eligibility against the MCCSS database.
Billing Tips
- Ensure the patient's ODSP number is accurately recorded in your billing software to prevent payment delays from the Ministry of Health acting as the paying agent.
- Since K055 is not an insured service under the Health Insurance Act, ensure your billing system is configured to process Appendix F codes separately from standard OHIP claims.
Effective: April 1, 2026
AF. Appendix F
MCSS ONTARIO DISABILITY SUPPORT PROGRAM (ODSP)
Procedure
Diagnostic and Therapeutic Procedures
Completion of the official 'Application for Special Diet Allowance' form is required.
Appendix F does not form part of the Schedule of Benefits: Physician Services under the Health Insurance Act and is reproduced for your information only.
This attachment is included in the publication for information purposes only.
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