K072 – Chronic home care supervision
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
The service rendered by a physician for personally providing medical advice, direction or information to health care staff of a Ontario Health atHome or an Ontario Health atHome contractor on behalf of a patient for whom the physician provides on-going medical care. This applies to chronic home care supervision, which is after the 8th week following admission to Ontario Health atHome home care program.
When to Use
- Use K072 for coordinating care with Ontario Health atHome staff for a patient who has been enrolled in the home care program for longer than 8 weeks.
- Use this code when providing specific medical direction to a home care nurse or coordinator regarding a patient's chronic condition management, provided no other visit code is billed that day.
Common Pitfalls
- Billing K072 on the same day as any office visit, consultation, or assessment code will result in a zero-dollar payment due to the mandatory exclusion rule.
- Attempting to bill K072 for patients residing in a nursing home or home for the aged will result in rejection, as these services are already bundled into the W010 monthly management fee.
- Failing to document the specific name of the Ontario Health atHome staff member contacted is a frequent cause of audit recovery.
Billing Tips
- Ensure the patient has surpassed the 8-week threshold from their initial home care admission date before submitting the first K072 claim to avoid automatic rejection.
- Limit billing to a maximum of two instances per month per patient to remain within the specific constraints for this code, even though the global limit for all providers is four.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
ManagementFee
Assessments
The date, medical advice, direction or information provided must be recorded in the patient's medical record.
If the information is provided verbally to staff, the name of the staff person must be recorded.
The amount payable for home care supervision without the required record of service in the patient's medical record is nil.
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