K683 – Opioid Agonist Maintenance Program monthly management fee - maintenance, per month
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Opioid Agonist Maintenance Program monthly management fee - maintenance, per month. This service is for the one month management and supervision of a patient receiving opioid agonist treatment by the physician most responsible for the management and supervision of that patient. This service includes the following specific elements: - a. All medication reviews, adjusting the dose of the opioid agonist therapy, and where appropriate, prescribing additional therapy, and discussions with pharmacists; - b. With the exception of all physician to physician telephone consultation services, discussion with, and providing advice and information to the patient, patient's relative(s), patient's representative or other caregiver(s), in person, by telephone or otherwise, on matters related to the service, regardless of identity of person initiating discussion; and - c. All discussions in respect of the patient's opioid dependency, except where the discussion is payable as a separate service.
When to Use
- Use K683 for patients in the maintenance phase of opioid agonist therapy who require routine dose adjustments and ongoing medication monitoring.
- Apply this code when the physician is the most responsible provider for the patient's OAMP management for the duration of the calendar month.
Common Pitfalls
- Billing K683 for patients still in the intensive phase, which should be billed under K682 instead.
- Attempting to bill telephone consultations or routine medication reviews separately; these are considered inclusive of the K683 management fee.
- Submitting the claim before the end of the month, as K683 is a monthly management fee that requires the full month's services to be rendered.
Billing Tips
- Always append K684 to your K683 claim if you are providing team-based care, as this is a simple way to capture the additional $6.00 premium.
- Unlike most other management fees, K683 can be billed on the same day as counselling codes like K013 or K033, allowing you to bill for psychotherapy sessions separately.
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