K267 – Periodic health visit - 2 - 11 years of age
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A periodic health visit (including a primary or secondary school examination) is performed on a patient, after their second birthday, who presents and reveals no apparent acute physical or mental illness. The service must include an intermediate assessment, a level 2 paediatric assessment or a partial assessment focusing on age and gender appropriate history, physical examination, health screening and relevant counselling. This code, K267, is for patients 2 to 11 years of age inclusive. For full definition see .
When to Use
- Use K267 for routine annual well-child checks for patients aged 2 through 11 when no acute illness is present.
- Use this code for school-entry or sports-participation physicals when the patient is asymptomatic and requires a comprehensive age-appropriate assessment.
Common Pitfalls
- Billing K267 on the same day as an acute illness visit (e.g., A007) is a common rejection; if an acute issue is addressed, you must bill the acute visit code instead.
- Exceeding the limit of one K267 per 12-month period per patient per physician will result in automatic rejection.
- Billing K267 alongside counselling codes like K013 or K040 is prohibited unless the counselling is for a distinct, unrelated diagnosis.
Billing Tips
- If a patient presents for a K267 but requires treatment for an acute issue, bill the appropriate assessment code (e.g., A007) and defer the periodic health visit to a later date.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments
The service must include an intermediate assessment, a level 2 paediatric assessment or a partial assessment focusing on age and gender appropriate history, physical examination, health screening and relevant counselling.
2 to 11 years of age inclusive
For definitions and payment rules - see General Preamble .
Diagnostic interview and/or counselling with child and/or parent - see listings in Family Practice & Practice in General.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.