K680 – Substance abuse - extended assessment
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A substance abuse - extended assessment is the service for providing care to patients receiving therapy for substance abuse. The service has the same specific elements as an assessment as defined in the Schedule of Benefits (, ).
When to Use
- Use K680 for an extended, comprehensive assessment of a patient struggling with alcohol or illicit drug dependency that exceeds the scope of a standard office visit.
- Apply this code when conducting a detailed, time-based psychiatric or psychosocial evaluation specifically focused on substance abuse treatment planning.
Common Pitfalls
- Billing K680 for smoking cessation management, which is strictly prohibited; use K039 instead.
- Submitting K680 on the same day as any other assessment, visit, or time-based service, which will trigger an automatic rejection.
- Failing to explicitly document start and stop times in the chart, which renders the claim ineligible for payment under GP7.
Billing Tips
- Ensure the total time documented reflects units of 30 minutes or major parts thereof, as K680 is a time-based service.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments, Psychotherapy, Psychiatric and Counselling Services
Start and stop times must be recorded in the patient's permanent medical record. As per general time-based service rules in , if the patient's permanent medical record or chart does not include this required information, the service is not eligible for payment.
1. K680 is a time based service with time calculated based on units. Unit means ½ hour or major part thereof – see General Preamble , for definitions and time-keeping requirements.
2. No other consultation, assessment, visit or time based service is eligible for payment when rendered the same day as K680 to the same patient by the same physician.
3. K680 is not eligible for payment for management of smoking cessation.
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