K630 – Psychiatric consultation extension
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A time-based service eligible for payment as an extension to specific psychiatric consultations (e.g., A190, C190, A195). It is payable when the physician is required to spend an additional period of consecutive or non-consecutive time on the same day with the patient, and/or the patient's relative(s), representative, or other caregivers. The time measurement for K630 excludes any time spent on separately billable interventions. Payment for K630 is only eligible after a minimum amount of time has been spent on the primary consultation service, as detailed in the payment rules on page . The amount payable is $117.40 per unit.
When to Use
- Use K630 when a complex psychiatric consultation (e.g., A190) exceeds the base time requirement due to extensive patient assessment or necessary collateral interviews with family members.
- Apply K630 when managing a crisis situation during an A195 consultation that requires additional time beyond the 60-minute base requirement to stabilize the patient or coordinate care.
Common Pitfalls
- Billing K630 alongside K001 is a common rejection; K630 is the exclusive time-based extension for psychiatric consultations, and K001 is explicitly prohibited on the same day.
- Failing to meet the specific 'base + extension' time thresholds (e.g., 106 minutes for A190 plus one unit of K630) will result in automatic claim rejection.
- Including non-patient-facing time, such as chart review or documentation, in the time calculation for K630 is a frequent audit trigger that leads to recovery of funds.
Billing Tips
- Maintain a precise log of start and end times for both the primary consultation and the extension period to satisfy the documentation requirements of GP7.
- Ensure that any separately billable interventions performed during the visit are subtracted from the total time before calculating the units of K630 eligible for payment.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Psychotherapy, Psychiatric and Counselling Services, Consultations
As per , the physician must record on the patient's permanent medical record or chart the time when the insured service started and ended.
The time unit measured excludes time spent on separately billable interventions.
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