K124 – Long-term care/Ontario Health atHome case conference
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
In addition to the definitions, required elements, payment rules, medical record requirements in the Preamble - Case conferences, a long-term care/Ontario Health atHome case conference is participation by the physician most responsible for the care of the patient and at least 2 other participants that include physicians, regulated social workers, employees of a Ontario Health atHome and/or regulated health professionals regarding a long-term care institution inpatient.
When to Use
- Use K124 when participating in a formal case conference for a patient residing in a long-term care (LTC) facility, involving at least two other eligible participants like nurses, social workers, or Ontario Health atHome staff.
- Choose K124 instead of K121 when the patient is in an LTC facility rather than an acute, chronic, or rehabilitation hospital setting.
Common Pitfalls
- Billing K124 for a simple telephone call or informal discussion that does not meet the Preamble requirement for a formal, multi-disciplinary case conference.
- Submitting K124 when the patient is an outpatient or resides in a private home, as this code is strictly limited to LTC institution inpatients.
- Failure to document the names and professional designations of the at least two other required participants, which leads to automatic audit rejection.
Billing Tips
- Ensure the total time spent is documented, as K124 is a flat-fee code that does not permit time-based unit multipliers unlike some K-codes in the K700 series.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Hospital and Institutional Consultations and Assessments, Interviews
Must adhere to the medical record requirements for case conferences as described in the General Preamble.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.