K706 – Convalescent care program case conference
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
In addition to the definitions, required elements, payment rules, and medical record requirements in the Preamble for Case conferences, a convalescent care case conference is participation by the physician most responsible for the care of the patient and at least 2 other participants that include physicians, regulated social workers, employees of the Convalescent Care Program and/or regulated health professionals regarding a patient enrolled in a Convalescent Care Program funded by the MOH.
When to Use
- Use K706 when participating in a formal case conference specifically for a patient currently enrolled in an MOH-funded Convalescent Care Program.
- Use this code when you are the most responsible physician coordinating care with at least two other required professionals, such as regulated social workers or program staff.
Common Pitfalls
- Billing K706 for patients in acute or chronic care facilities, which instead requires K121 or K705/K124 respectively.
- Failing to meet the minimum three-participant threshold, which is a common cause for audit recovery.
- Confusing K706 with K700-K704, which are strictly reserved for out-patient case conferences and do not apply to convalescent care settings.
Billing Tips
- Ensure your documentation explicitly lists the names and professional designations of the two required participants to satisfy the specific requirements of A40.
- Verify the patient's enrollment status in the MOH-funded Convalescent Care Program before billing to avoid automatic rejection for ineligible patient conditions.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Assessments
Must adhere to the medical record requirements for case conferences as defined in the Preamble of the Schedule of Benefits.
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