K059 – Health Status Report of Part B for Medical Review process
OHIP Consultation & Visit Premium Codes Code — MCSS ONTARIO DISABILITY SUPPORT PROGRAM (ODSP) · Schedule of Benefits
K059 is the fee for completing the Health Status Report of Part B, when completed separately, for the ODSP Medical Review process. Appendix F of the Schedule of Benefits notes that this service is not an 'insured service' under the Health Insurance Act but is paid by the Ministry of Health acting as a paying agent on behalf of the Ministry of Community and Social Services (MCSS).
When to Use
- Use K059 when you are specifically completing only the 'Health Status Report' (Part B) for an ODSP Medical Review without the Activities of Daily Living Index.
- Use this code when the patient presents specifically for the completion of the Part B medical review documentation as requested by the Disability Adjudication Unit.
Common Pitfalls
- Billing K059 in conjunction with K058 will result in an automatic rejection, as K058 is intended for the combined completion of the Health Status Report and the Activities of Daily Living Index.
- Submitting K059 for general disability forms or insurance reports not associated with the official ODSP Medical Review process will lead to claim denial.
Billing Tips
- Ensure the patient has been formally notified of the ODSP Medical Review requirement, as the Ministry verifies the eligibility of the request against the patient's file before payment.
Effective: April 1, 2026
AF. Appendix F
MCSS ONTARIO DISABILITY SUPPORT PROGRAM (ODSP)
Other
Other Premiums (including After Hours Procedure Premiums)
Completion of the official 'Health Status Report' of Part B for the ODSP Medical Review process.
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.
The services set out below are not 'insured services' within the meaning of the Health Insurance Act but are paid by the Ministry of Health, acting as paying agent on behalf of the Ministry of Children, Community and Social Services (MCCSS), the Ministry of the Attorney General, the Ministry of the Solicitor General, and the Workplace Safety and Insurance Board (WSIB).
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