K715 – Multidisciplinary respiratory case conference
OHIP Consultation & Visit Premium Codes Code · Schedule of Benefits
Participation by the physician most responsible for the care of the patient and at least 2 other participants that include physicians, regulated social workers and/or regulated health professionals regarding a patient with interstitial lung disease.
When to Use
- Use K715 when coordinating care for an interstitial lung disease patient with at least two other regulated health professionals, such as a respirologist, a physiotherapist, and a social worker.
- Use K715 for scheduled multidisciplinary team meetings specifically focused on complex treatment planning for ILD, provided the meeting is not for educational rounds or general staff meetings.
Common Pitfalls
- Billing K715 on the same day as an office visit or any other insured service for the same patient will result in a rejection, as case conferences are exclusive of other services.
- Claiming K715 for meetings involving only staff members who are paid by the physician or who are trainees, as these do not meet the 'regulated health professional' participant requirement.
- Exceeding the 4-service annual limit per patient, which is strictly monitored by OHIP and will trigger automated recovery of funds.
Billing Tips
- Ensure your documentation explicitly lists the start and end times and the names/designations of the two required participants to avoid audit clawbacks.
- If you are part of an APP or salary-based model, you are ineligible to bill K715; ensure your billing system flags these encounters to prevent non-compliant submissions.
Effective: April 1, 2026
Case Conference
Consultation
The meeting must be pre-scheduled.
The purpose must be for discussing and directing the management of an individual patient.
Minimum of 10 minutes of patient-related discussion is required.
The physician must actively participate, and this participation must be evident in the record.
Medical record must include: patient identification, start and stop times of the discussion, identification of eligible participants, and the outcome or decision of the conference.
Services described in the supervision of postgraduate medical trainees section are not eligible for payment as K715.
Not eligible for payment if the required participants receive remuneration from the physician claiming the service.
Not eligible for payment to a physician who receives payment other than fee-for-service (e.g., salary, APP, AFP) for the preparation or participation in the conference.
Not eligible if the case conference is an included element of another service (e.g., chronic dialysis team fees).
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