K209 – Group psychotherapy, out-patients - 3 people - per member - per unit
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A unit of group psychotherapy for an out-patient session with 3 people. Psychotherapy is the treatment for mental illness, behavioural maladaptations, or other emotionally-based problems where a physician establishes a professional relationship with a patient to modify symptoms, reverse disturbed behaviour patterns, and promote positive personality growth. A time unit is defined as ½ hour or a major part thereof, with a minimum of 20 minutes of direct contact with the physician required for the first unit. This fee is payable per member.
When to Use
- Use K209 when facilitating a structured psychotherapy session for exactly 3 patients simultaneously, ensuring each patient's record reflects the specific start and end times.
- Select K209 over individual psychotherapy codes like K007 when the clinical objective is to leverage group dynamics to address mental health symptoms for a trio of patients.
Common Pitfalls
- Billing K209 for a group of 4 or more patients, which requires using K208 instead to avoid rejection or audit recovery.
- Failing to document the exact start and end times in each of the three patients' charts, which is a mandatory requirement for all unit-based psychotherapy services.
- Attempting to bill an assessment code (e.g., A007) on the same day as K209 for the same patient without a distinct, unrelated diagnosis, which will trigger an automatic rejection.
Billing Tips
- Ensure the session duration is at least 20 minutes to qualify for the first unit, as services under this threshold do not meet the definition of psychotherapy and may be downgraded to a standard visit code.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Procedure
Psychotherapy, Psychiatric and Counselling Services
For unit-based services, the physician must record the start and end times of the service in the patient's permanent medical record.
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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.