K143 – Chronic disease shared appointment - 5 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 two or more 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. 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 (see ).
When to Use
- Use K143 when facilitating a group session for exactly five patients who all share the same qualifying chronic diagnosis, such as Diabetes or COPD.
- Use this code when providing a structured educational session combined with individual clinical assessments for five patients, rather than billing individual A007 office visits.
Common Pitfalls
- Billing K143 when the group size is not exactly five patients, as the Ministry requires the specific code corresponding to the exact number of participants (K140-K144).
- Submitting K143 for patients with different chronic conditions in the same session, as the policy mandates all participants must share the same diagnosis.
- Attempting to bill an additional office assessment (A007) on the same day for the same patient unless the visit is for a completely unrelated diagnosis.
Billing Tips
- Ensure the chart notes for each of the five patients clearly document the start and end times of the shared appointment to satisfy the time-based documentation requirement.
- Confirm that the physician remains in constant personal attendance for the entire session, even if a nurse or educator leads the teaching portion, to maintain eligibility for the fee.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments
For time-based services, 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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