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Palliative care OHIP billing codes
Palliative care consultations, support and visits in hospital, long-term care and at home, with case management, phone management and home special-visit premiums.
15 codes in 5 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 45 is in the full Palliative Medicine listing.
Consultations
Support & case management
- K023Palliative care supportPalliative care support is a time-based service payable for providing pain and symptom management, emotional support and counselling to patients receiving palliative care.$85.25
- G512Palliative care case management feeA weekly case management fee for the most responsible physician providing supervision and coordination of palliative care for a patient, billable once per week.$67.75
- G511Telephone management regarding a patient receiving palliative care at homeA per-call fee for telephone management of a patient receiving palliative care at home.$18.20
- K700Palliative care out-patient case conferenceA time-based case conference for a palliative care out-patient, involving the most responsible physician and at least two other healthcare professionals to discuss patient management.$37.05
Hospital in-patient visits
- C882Palliative careA palliative care visit rendered by the Most Responsible Physician (MRP) to a patient in a designated palliative care bed.$40.05
- C982Palliative careA routine assessment by the most responsible physician (MRP) for providing palliative care to a patient in a designated palliative care bed within a hospital setting.$40.05
Long-term care & chronic care visits
- W872Nursing home or home for the aged - palliative careA subsequent palliative care visit for a terminally ill patient in a long-term care institution.$40.05
- W972Nursing home or home for the aged - palliative careA subsequent visit by a specialist to a patient in a long-term care institution for the purpose of providing palliative care.$40.05
- W882Chronic care or convalescent hospital - palliative careA subsequent visit for palliative care to a patient in a chronic care or convalescent hospital who is not in a designated palliative care bed (see GP50).$40.05
- W982Chronic care or convalescent hospital - palliative careA palliative care subsequent visit to a patient in a chronic care or convalescent hospital who is not in a designated palliative care bed (see GP50).$40.05
How to use this palliative care code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to palliative medicine (specialty 45) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a palliative care physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does palliative care bill?
The consultations section of this set starts with A945 (Special palliative care consultation), which pays $174.25 under the current Ontario Schedule of Benefits. 2 codes are listed in that section.
What is in the Palliative care code set?
15 OHIP billing codes across 5 sections: Consultations; Support & case management; Hospital in-patient visits; Long-term care & chronic care visits; Home special visit premiums. Palliative care consultations, support and visits in hospital, long-term care and at home, with case management, phone management and home special-visit premiums.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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