All codes
K203
K203 – Group psychotherapy - 4 people per unit
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Group psychotherapy for 4 people in an out-patient setting, billed per member, per unit. A unit is defined as 1/2 hour or a major part thereof.
Definition of Psychotherapy:
Psychotherapy is a form of treatment for mental illness, behavioural maladaptations, and/or other problems that are assumed to be of an emotional nature. A physician establishes a professional relationship with the patient with the purpose of removing, modifying, or retarding existing symptoms, attenuating or reversing disturbed patterns of behaviour, and promoting positive personality growth and development (from ).
Specific Elements:
In addition to common elements, this service includes:
• Performing the appropriate therapy or interaction with the patient(s).
• Performing any procedures during the same encounter unless separately listed.
• Making arrangements for related assessments, procedures, or therapy.
• Making arrangements for follow-up care.
• Discussion and providing advice to the patient or representative.
• Monitoring the patient's condition when medically indicated.
• Providing premises, equipment, supplies, and personnel.
(from )
Claims Submission:
The claim must be submitted under the health number of the group member for whom, when the service was rendered, the largest number of counselling units had previously been claimed by the physician during the year in which the service is rendered (from ).
The physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
The physician must also maintain a separate record (independent of the patient's medical record) of the names and health numbers of all persons in attendance at each group psychotherapy session.
For conditions and definitions - see General Preamble to .
Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
Claims Submission Instruction: The claim must be submitted under the health number of the group member for whom, when the service was rendered, the largest number of counselling units had previously been claimed by the physician during the year in which the service is rendered.
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