K142 – Chronic disease shared appointment - 4 patients
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Chronic disease shared appointment is a pre-scheduled primary care service rendered for chronic disease management, to a group of 4 patients with the same diagnosis of one of the diseases listed below, that consists of assessment and the provision of advice and information in respect of diagnosis, treatment, health maintenance and prevention. Each patient must have an established diagnosis of one of the following chronic diseases: - Diabetes - Congestive Heart Failure - Asthma - Chronic obstructive pulmonary disease (COPD) - Hypercholesterolemia - Fibromyalgia The physician must be in constant personal attendance for the duration of the appointment session, although another appropriately qualified health professional may lead parts of the educational component of the session (for example, a diabetic educator or nurse). In addition, a clinically appropriate assessment must be rendered to each patient by the same physician as a component of the chronic disease shared appointment. This service has the same specific elements as an assessment as outlined in .
When to Use
- Use K142 when you have exactly four patients with the same qualifying chronic diagnosis present for a structured group education and individual assessment session.
- Use this code for planned group sessions focused on management and prevention for conditions like Diabetes or COPD, provided the session includes an individual assessment for each participant.
Common Pitfalls
- Billing K142 when fewer than four patients are present; you must use K141 for three patients or K140 for two patients to avoid rejection.
- Failing to document the specific start and end times of the session, which is a mandatory requirement for all K-series shared appointment codes.
- Attempting to bill an additional office visit (A007) on the same day for the same patient without a distinct, unrelated diagnosis, which will trigger an automatic rejection.
Billing Tips
- Ensure the chart note for each of the four patients explicitly documents the individual assessment performed during the group session to satisfy the GP15 assessment requirements.
- Submit a separate claim for each of the four patients using K142, ensuring the diagnosis code matches the chronic condition being managed in the group.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments
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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