K111 – Air ambulance transfer with patient
OHIP Consultation & Visit Premium Codes Code — GENERAL PREAMBLE · Schedule of Benefits
Detention-in-Ambulance is payable for constant attendance with a patient in an ambulance, to provide all aspects of care to the patient. Time is calculated only for that period during which the physician is in constant attendance with the patient in the ambulance. The service includes an initial examination and ongoing monitoring of the patient's condition and all interventions, except in those circumstances in which the Schedule provides for separate or additional payment for the intervention. As per , the start and end times must be recorded in the patient's medical record.
When to Use
- Use K111 when providing constant, active medical attendance to a patient during an air ambulance transfer, distinct from routine transport monitoring.
- Use K111 for non-elective transfers where you are the primary physician responsible for ongoing care and interventions during the transit period.
Common Pitfalls
- Failure to submit a detailed written explanation with the claim will result in automatic rejection, as K111 is assessed on an IC (Individual Consideration) basis.
- Claiming K111 for time spent waiting for the ambulance or during transit without providing active, constant medical attendance will be denied upon audit.
- Neglecting to document the exact start and end times of the constant attendance in the patient's chart is a frequent cause for recovery of funds during OHIP audits.
Billing Tips
- Always append the appropriate after-hours premium (E409 or E410) if the transfer occurs during the specified time windows, as these are specifically eligible for K111.
- Include a concise, clear narrative of the clinical interventions performed during the transfer in your submission to satisfy the medical consultant's requirement for IC assessment.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Procedure
Assessments
Claims for Detention-in-Ambulance are assessed by a medical consultant on an IC basis and require the submission of a written explanation.
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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