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K313
K313 – Physiatric management
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Physiatric management is the service rendered by physiatrists for regulation, management and supervision of the active, regular, and ongoing treatment of a patient in a rehabilitation department by physical or other (e.g. occupational, speech) therapists. The service also includes making arrangements for any related assessments, procedures or therapy and making arrangements for follow-up care as required.
When to Use
- Use K313 when you are actively adjusting a patient's rehabilitation plan based on progress reports from PT, OT, or SLP staff for a patient you have previously assessed.
- Use K313 during the active phase of inpatient rehabilitation when you are coordinating discharge planning and therapy adjustments, provided no other clinical service is billed that day.
Common Pitfalls
- Billing K313 on the same day as a subsequent visit (A033) or a consultation (A313) will result in an automatic rejection.
- Claiming K313 as a routine administrative fee for department oversight is an audit risk; it must be tied to specific, documented therapy adjustments for an individual patient.
- Submitting K313 on days when no actual therapy (PT, OT, or SLP) was provided to the patient violates the requirement that rehabilitation services must occur on the same day.
Billing Tips
- Ensure your documentation explicitly links the K313 claim to a specific therapy intervention or adjustment made on that date to satisfy the requirement for active, ongoing management.
Provider Fee$0.00
Specialist Fee$8.10
Effective: April 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
ManagementFee
Code Classes
Assessments
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