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K125
K125 – Intellectual and Developmental Disability Primary Care
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Primary care of patients with intellectual and developmental disabilities which includes any combination of common elements and specific elements of any insured service listed under “Family Practice & Practice In General” in the “Consultations and Visits” section and, in all cases, includes the same minimum time period requirements described for counselling in the General Preamble . When a physician submits a claim for rendering any other consultation or visit to the same patient on the same day for which the physician submits a claim for Intellectual and Developmental Disability Primary Care, the Intellectual and Developmental Disability Primary Care service is included (in addition to the common elements) as a specific element of the other insured service. Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
The service must meet the minimum time period requirements described for counselling (/).
A diagnostic code corresponding to the patient’s condition must accompany the claim for payment purposes.
OHIP diagnostic codes: 299, 319, 343, 741, 758
Time units must be calculated based upon consecutive time spent rendering the service.
Calculation of time excludes non-patient-facing time (e.g., charting, reviewing imaging).
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