K208 – Group psychotherapy, out-patients - 2 people
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Group psychotherapy for 2 out-patients, per member, per unit. A unit is defined as one half-hour or a major part thereof, with a minimum of 20 minutes of direct contact with the patient required for the first unit. Refer to for detailed time requirements for multiple units. Definition: Psychotherapy is any 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 (). Notes from the Schedule: - For conditions and definitions, see General Preamble to . - For electroconvulsive therapy fees, see the Diagnostic and Therapeutic Procedures section. - When claiming group therapy, only services rendered to one group are payable at the same time.
When to Use
- Use K208 when conducting a structured psychotherapy session for exactly two out-patients simultaneously, where the focus is on emotional or behavioural modification.
- Select K208 instead of K209 when the group size is strictly limited to two participants, as K209 is intended for groups of three or more.
Common Pitfalls
- Billing K208 on the same day as a consultation or assessment (e.g., A005) for the same patient will trigger an automatic rejection unless you document distinct, unrelated diagnoses for each service.
- Failing to record exact start and end times in the chart is the most common cause of audit recovery; simply noting '30 minutes' is insufficient to meet the GP7 documentation requirement.
- Claiming K208 for sessions lasting less than 20 minutes, as the first unit requires a minimum of 20 minutes of direct contact to be eligible for payment.
Billing Tips
- If the session extends beyond the first 12 units, you must switch to billing K206 for the additional time units to ensure proper processing.
- Ensure your documentation explicitly reflects that the service was a group session for two, as this distinguishes the claim from individual psychotherapy codes like K013.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Psychotherapy
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 ().
1. For conditions and definitions - see General Preamble to . 2. For electroconvulsive therapy fees, see Diagnostic and Therapeutic Procedures. 3. When claiming group therapy only services rendered to one group are payable at the same time. 4. Unit means ½ hour or major part thereof - see General Preamble , for definitions and time-keeping requirements.
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