K194 – Hypnotherapy - Group - for induction and training for hypnosis - per member (maximum eight people)
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Group hypnotherapy for induction and training for hypnosis, billed per member for a maximum of eight people, per unit of time. Definition Hypnotherapy is a form of treatment that has the same goals as psychotherapy but is rendered with the patient under hypnosis (:). Specific Elements In addition to the common elements, all Hypnotherapy services include the following specific elements (:): - Performing the appropriate therapy or interaction with the patient(s). - Performing any procedures during the same encounter unless separately payable. - Making arrangements for related assessments, procedures, or therapy. - Making arrangements for follow-up care. - Discussion with and providing advice/information to the patient or patient's representative. - Monitoring the patient's condition when medically indicated. - Providing premises, equipment, supplies, and personnel for the specific elements of the service.
When to Use
- Use K194 when conducting a structured group session of up to eight patients focused on teaching self-hypnosis techniques for chronic pain management or anxiety reduction.
- Select K194 for group-based induction training sessions that meet the minimum 20-minute duration threshold, distinguishing it from individual K192 sessions.
Common Pitfalls
- Billing K194 on the same day as a consultation or assessment (e.g., A007) for the same patient will trigger an automatic rejection unless distinct, unrelated diagnoses are documented for each service.
- Failing to record the exact start and end times in the patient chart is a frequent audit failure that results in total clawback of the fee.
- Billing K194 for sessions lasting less than 20 minutes is prohibited; such encounters must be billed as a standard assessment code based on the time spent.
Billing Tips
- Ensure the group size does not exceed eight members, as the Ministry will reject claims exceeding this limit for a single session.
- When billing K194, ensure the clinical note clearly distinguishes the group hypnotherapy encounter from any other services provided to the same patient on that date to satisfy the 'different diagnosis' requirement.
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. If the patient's permanent medical record or chart does not include this required information, the service is not eligible for payment.
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.
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