K189 – Urgent Community Psychiatric Follow-up
OHIP Consultation & Visit Premium Codes Code — Psychiatry (19) · Schedule of Benefits
A premium added to specific psychiatric assessments (A190, A195, A192, A198, A695, or A795) for providing urgent follow-up care to a patient within four weeks of discharge from a psychiatric hospitalization. This premium is only payable if the billing psychiatrist did not provide services to the patient during that hospital stay and commits to providing ongoing care for at least six months.
When to Use
- Use K189 when performing an urgent initial consultation (A190) or assessment (A195) for a patient discharged from a psychiatric unit within the last 28 days, provided you were not the attending psychiatrist during that admission.
- Apply this premium when accepting a new patient for long-term management following a recent psychiatric hospitalization, ensuring the claim is linked to an eligible assessment code like A192 or A198.
Common Pitfalls
- Billing K189 when you were the psychiatrist of record during the patient's recent hospital admission, which is a direct violation of the eligibility criteria.
- Submitting K189 more than once per patient per 12-month period, as the system will automatically reject subsequent claims regardless of new hospitalizations.
- Attempting to claim K189 alongside K188 for the same patient on the same day, as these are mutually exclusive billing codes.
Billing Tips
- Ensure your clinical notes explicitly state the date of hospital discharge and your commitment to a six-month follow-up plan to satisfy audit requirements for this premium.
- Verify the patient's discharge date against the hospital record before billing, as the four-week window is strictly calculated from the date of discharge to the date of the outpatient service.
Effective: April 1, 2025
Consultations and Visits
Psychiatry (19)
Premium
Other Premiums (including After Hours Procedure Premiums), Psychotherapy, Psychiatric and Counselling Services
1. K189 is only eligible for payment when the psychiatrist providing the urgent community psychiatric follow-up: a. renders a service described by A190, A195, A192, A198, A695 or A795 to an out-patient on an urgent basis during the four (4) week period immediately following discharge where the patient was a hospital in-patient for treatment of a psychiatric condition; b. did not provide services to the same patient during the same psychiatric hospital admission; and c. will continue appropriate care of the out-patient for a minimum of six (6) months as required.
2. K189 is limited to a maximum of one per physician per patient per 12 month period.
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