K192 – Hypnotherapy - Individual
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Hypnotherapy is a form of treatment that has the same goals as psychotherapy but is rendered with the patient under hypnosis. In addition to the common elements, all Psychotherapy, Hypnotherapy, Counselling, Primary Mental Health, and Psychiatric Care include the following specific elements (from ): A. Performing the appropriate therapy or interaction with the patient(s) or, in the case of K014, K015, and H313, the patient’s relative(s) or patient’s representative, which may include the appropriate inquires (including obtaining a patient history, and a brief physical examination) carried out in order to arrive at an opinion as to the nature of the patient’s condition (whether such inquiry takes place before, during or after the encounter during which the therapy or other interaction takes place); any appropriate procedure(s), related service(s), and/or follow-up care. B. Performing any procedure(s) during the same encounter as the therapy or other interaction unless the procedure(s) is(are) separately listed in the Schedule and an amount is payable for the procedure in conjunction with the therapy or interaction. C. Making arrangements for any related assessments, procedures, or therapy. D. Making arrangements for follow-up care. E. Discussion with, and providing advice and information, including prescribing therapy to the patient or the patient’s representative, whether by telephone or otherwise, on matters related to: a. the service; and b. in circumstances in which it would be professionally appropriate that results can be reported upon prior to any further patient visit, the results of related procedure(s) and/or assessment(s). F. When medically indicated, monitoring the condition of the patient and intervening, until the next insured service is rendered. G. Providing premises, equipment, supplies, and personnel for the specific elements of the service. While no occasion may arise for performing elements B, C, D and F, when performed in connection with the other specific elements they are included in the service. Payment rules (from ): 2. Except for in-patient individual psychotherapy by a psychiatrist or in-patient individual psychiatric care for which the time can be consecutive or non-consecutive, for all other services in this section the time units must be calculated based upon consecutive time spent rendering the service. Commentary (from ): 1. Except as noted in payment rule #2 (where non-consecutive services can be cumulated), services less than 20 minutes do not constitute any of the services defined in this section and constitute the type of assessment rendered in the circumstances.
When to Use
- Use K192 when the primary therapeutic intervention is the induction of a hypnotic state to address a specific diagnosis, such as chronic pain management or smoking cessation, rather than standard talk therapy.
- Select K192 when the session duration meets the minimum 20-minute threshold, distinguishing it from a standard office visit (A007) which would be billed if the session is shorter.
Common Pitfalls
- Billing K192 on the same day as a consultation (A005/A007) without documenting distinct, separate diagnoses for each service will result in an automatic rejection.
- Failing to record the exact start and end times in the clinical note is a primary cause for audit recovery, as the Ministry strictly enforces the 20-minute minimum for this code.
- Attempting to bill K192 for sessions under 20 minutes; these must be billed as a standard office visit (A007) as they do not meet the definition of psychotherapy/hypnotherapy services.
Billing Tips
- Ensure your documentation explicitly describes the hypnotic technique used, as this distinguishes K192 from standard psychotherapy codes like K013 or K194.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Psychotherapy, Psychiatric and Counselling Services
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
Services less than 20 minutes in duration do not constitute any of the services defined in this section and constitute the type of assessment rendered in the circumstances.
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