K190 – Individual in-patient psychotherapy
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Individual in-patient psychotherapy is a form of treatment for mental illness, behavioural maladaptations, and/or other problems assumed to be of an emotional nature, where a physician deliberately establishes a professional relationship with an individual patient in a hospital setting. The purpose is to remove, modify, or retard existing symptoms, attenuate or reverse disturbed patterns of behaviour, and promote positive personality growth and development. This service is time-based, with payment calculated in units of 1/2 hour. For conditions and definitions, see the General Preamble sections to .
When to Use
- Use K190 when providing formal, time-based psychotherapy to an admitted hospital patient for mental health conditions, provided the session duration is at least 20 minutes.
- Use K190 instead of a subsequent hospital visit (C002) when the primary focus of the encounter is therapeutic intervention rather than routine medical management or physical assessment.
Common Pitfalls
- Billing K190 on the same day as a subsequent hospital visit (C002) will trigger an automatic rejection, as these are mutually exclusive for the same patient on the same day.
- Claiming K190 for sessions lasting less than 20 minutes is a common audit trigger; such encounters should be billed as a standard hospital visit (C002) instead.
- Failing to document precise start and end times in the chart is the most frequent cause of clawbacks during OHIP audits for time-based psychotherapy codes.
Billing Tips
- Since K190 is billed in 30-minute units, ensure the total time documented justifies the number of units claimed, keeping in mind that a 'major part' (at least 20 minutes) constitutes one unit.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Procedure
Psychotherapy, Psychiatric and Counselling Services
The physician must record the start and end time of the service in the patient's permanent medical record or chart.
For conditions and definitions - see General Preamble to .
For electroconvulsive therapy fees, see Diagnostic and Therapeutic Procedures.
Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
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