K705 – Long-term care – high risk patient conference
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A Long-term care – High risk patient case conference is participation by a physician and at least 2 other participants that include physicians, employees of Ontario Health atHome, regulated social workers and/or regulated health professionals regarding a long-term care institution high risk inpatient. For the purposes of K705, a high risk patient is a patient identified by staff in the long term institution with clinical instability based on a change in the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) for Nursing Homes. This service is billable per unit, with limits on the number of services per year and units per day.
When to Use
- Use K705 when participating in a multidisciplinary case conference for a long-term care resident who has triggered a significant change in their RAI-MDS assessment.
- Use K705 specifically for high-risk residents where the conference involves at least two other eligible participants, such as Ontario Health atHome staff or regulated health professionals.
Common Pitfalls
- Billing K705 for standard multidisciplinary team meetings that do not meet the specific RAI-MDS clinical instability criteria for a 'high risk' patient.
- Failing to record the exact start and end times in the patient chart, which is a mandatory requirement for all time-based case conference codes per GP7.
- Confusing K705 with K700-K704; K705 is exclusively for long-term care high-risk inpatients, whereas the K700 series is intended for out-patient case conferences.
Billing Tips
- Ensure the patient's chart explicitly references the RAI-MDS change that triggered the high-risk status to justify the use of K705 over other conference codes.
- Verify that the two required participants are present and documented by name and discipline to avoid rejection during a post-payment audit.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Assessments
In addition to common medical record requirements, the record must include the start and end time of the conference, as required for all time-based services per .
In circumstances where the physician other than the physician most responsible for the care of the patient participates in the case conference, K705 is only eligible for payment when the physician's participation is for directing the care of the individual patient.
For the purposes of K705, a high risk patient is a patient identified by staff in the long term institution with clinical instability based on a change in the Resident Assessment Instrument – Minimum Data Set (RAI-MDS) for Nursing Homes.
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