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K206
K206 – Group psychotherapy out-patients - additional units
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
K206 is for additional units of group psychotherapy for out-patients, payable per member, per unit.
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, where a physician deliberately establishes a professional relationship with a patient with the purpose of removing, modifying or retarding existing symptoms, or attenuating or reversing disturbed patterns of behaviour, and of promoting positive personality growth and development.
This service is for additional units of group psychotherapy for out-patients, after the first 12 units per day (billed under codes K208 to K205) have been rendered to the group. A maximum of 6 additional units using K206 may be claimed per patient per day.
Unit and Time Requirements
A unit is defined as ½ hour or a major part thereof. The time is calculated based on consecutive time spent with the patient(s). The minimum time requirements are:
• 1 unit: 20 minutes
• 2 units: 46 minutes
• 3 units: 76 minutes
• 4 units: 106 minutes
• 5 units: 136 minutes
• 6 units: 166 minutes
• 7 units: 196 minutes
• 8 units: 226 minutes
Services less than 20 minutes in duration do not constitute psychotherapy and should be claimed as an assessment appropriate to the circumstances.
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.
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.
When claiming group therapy only services rendered to one group are payable at the same time.
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