K202 – Group psychotherapy, in-patients - 6 to 12 people - per member - per unit
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
K202 is for group psychotherapy for in-patients, billed per member for a group size of 6 to 12 people. Psychotherapy is a form of treatment for mental illness, behavioural maladaptations, or other problems of an emotional nature. The service is time-based, with a unit representing a half-hour or major part thereof. See to for detailed definitions and conditions.
When to Use
- Use K202 when facilitating a structured psychotherapy session for an inpatient group of 6 to 12 patients, where the session duration is at least 20 minutes.
- Choose K202 over K200 or K201 when the group size exceeds 5 participants, as K200/K201 are restricted to smaller group cohorts.
Common Pitfalls
- Billing K202 for sessions lasting less than 20 minutes, which will result in a rejection or audit recovery as the service fails to meet the 'major part' of a 30-minute unit requirement.
- Failing to maintain the mandatory separate log of all patient health numbers present in the group, which is a primary trigger for OHIP audit clawbacks.
- Attempting to bill K202 on the same day as individual psychotherapy (K191) for the same patient, which is explicitly prohibited under GP56.
Billing Tips
- Ensure the start and end times are explicitly documented in each patient's individual chart, as the Ministry requires this to validate the time-based unit claim.
- If the session exceeds 30 minutes, you may bill multiple units of K202, provided the total time spent is documented and reflects the 'major part' of each additional 30-minute block.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Psychotherapy
Psychotherapy, Psychiatric and Counselling Services
The physician must record the start and end times of the service in the patient's permanent medical record.
A separate record must be maintained (independent of the patient's medical record) with the names and health numbers of all persons in attendance at each group psychotherapy session.
For conditions and definitions - see General Preamble to .
For electroconvulsive therapy fees, see Diagnostic and Therapeutic Procedures.
When claiming group therapy only services rendered to one group are payable at the same time.
Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
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