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Psychiatry OHIP billing codes
Psychiatric consultations, psychotherapy and psychiatric care by setting, group therapy, Mental Health Act forms, community care premiums and ECT.
62 codes in 11 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 19 is in the full Psychiatry listing.
Consultations & assessments — office
- A195Psychiatric Consultation—
- A190Special psychiatric consultation—
- A395Limited ConsultationA limited consultation rendered by a psychiatrist which is less demanding and time-consuming than a full consultation (<billingCode>A195</billingCode>) but otherwise has the same requirements, including a written request from a referring practitioner.—
- A196Repeat psychiatric consultation—
- A193Specific assessmentSpecific assessment (Psychiatry)—
- A194Partial assessmentPartial assessment (Psychiatry)—
- A795Geriatric psychiatric consultation—
- A695Neurodevelopmental ConsultationNeurodevelopmental consultation for an adult with complex neurodevelopmental conditions.—
- A191Consultative interview with caregiver(s) of a patient (65+ or dementia)—
- A192Consultative interview - patient 65+ or with dementia—
- A197Consultative interview on behalf of disturbed patient (including report) - consultative interview with parent(s) or patient representative(s) of patient less than age 22Consultative interview with parent(s)/representative(s) of a disturbed patient < 22 years old.—
- A198Consultative interview with patient less than age 22Consultative interview with patient < age 22—
- A895Consultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patientConsultation in association with special visit—
Psychotherapy & psychiatric care — out-patient
- K197Individual out-patient psychotherapyTime-based service for individual out-patient psychotherapy, paid per half-hour unit. A minimum of 20 minutes of direct physician-patient contact is required for the first unit.—
- K198Out-patient psychiatric careTime-based psychiatric care for an out-patient, including assessment and treatment for mental illness or behavioural issues. This service is billed in units of ½ hour, with a minimum of 20 minutes required for the first unit.—
- K195Family psychotherapy - out-patients (two or more members)Payable per half-hour unit for family psychotherapy for out-patients, rendered to a patient in the presence of two or more family members. Service must meet the time requirements for psychotherapy as defined in the Schedule of Benefits.—
- K196Family psychiatric care - out-patientA time-based service for out-patient family psychiatric care, provided by a psychiatrist, involving the patient and one or more family members or professional caregivers. The service is calculated in 30-minute units.—
- K192Hypnotherapy - IndividualIndividual hypnotherapy service, a form of treatment with goals similar to psychotherapy but rendered under hypnosis. This is a time-based service billed in units, with the first unit requiring a minimum of 20 minutes of consecutive, direct patient contact.—
- K189Urgent Community Psychiatric Follow-upA premium for an urgent psychiatric follow-up to an out-patient within 4 weeks of hospital discharge. The service must be provided by a psychiatrist who did not manage the in-patient care and who commits to ongoing care.—
Group psychotherapy — out-patient
- K208Group psychotherapy, out-patients - 2 peopleGroup psychotherapy for 2 out-patients, per member, per unit. A unit consists of one half-hour or major part thereof. This service is for the first 12 units per member per day.—
- K209Group psychotherapy, out-patients - 3 people - per member - per unitPayable per member for a unit (½ hour) of group psychotherapy for 3 out-patients. This fee applies to the first 12 units per patient per day.—
- K203Group psychotherapy, out-patients - 4 peoplePayable per member, per unit for outpatient group psychotherapy involving 4 people. A unit is a 1/2 hour or major part thereof, with a minimum of 20 minutes required for the first unit. Limited to the first 12 units per member per day.—
- K204Group psychotherapy, out-patients - 5 people - per unitUnit-based fee for group psychotherapy provided to a group of 5 out-patients. This service is billed per member per half-hour unit, for the first 12 units per day.—
- K205Group psychotherapy, out-patients - 6 to 12 peopleProvides payment per member, per half-hour unit for group psychotherapy for a group of 6 to 12 out-patients. This code is applicable for the first 12 units per day.—
- K206Group psychotherapy, out-patients - additional unitsPayable per-member, per-unit for group psychotherapy for out-patients. This code is for additional units beyond the initial 12 units per day for the group, with a maximum of 6 additional units per patient per day.—
Hospital in-patient consultations & visits
- C190Special Psychiatric ConsultationA special psychiatric consultation for a hospital in-patient, subject to the same conditions as a non-hospital special psychiatric consultation (`<billingCode>A190</billingCode>`). This service requires the physician to devote a minimum of 90 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.—
- C192Psychiatric consultationA routine in-patient assessment rendered by a psychiatrist to a non-emergency hospital patient during the first five weeks of admission, limited to one per day.—
- C193Psychiatric consultationSpecific assessment—
- C194Psychiatric consultationA specific re-assessment for a non-emergency hospital in-patient rendered by a psychiatrist, requiring a full, relevant history and physical examination of one or more systems.—
- C196Repeat ConsultationA repeat consultation for a hospital in-patient by a psychiatrist. This is an additional consultation for the same problem, requested after another physician has provided care in the interim, and requires a new written referral.—
- C197Subsequent VisitA routine subsequent visit for a hospital in-patient, rendered by a psychiatrist from the sixth to the thirteenth week of hospitalization inclusive, with a maximum of three visits per patient per week.—
- C198Concurrent CareA routine in-hospital assessment by a consultant providing continued directive care at the request of the patient's most responsible physician (MRP). Subject to weekly limits.—
- C199Subsequent Visit - After Thirteenth WeekA routine subsequent visit by a psychiatrist for a non-emergency hospital in-patient after the 13th week of admission. Limited to a maximum of six visits per patient per month.—
- C795Geriatric Psychiatric ConsultationA geriatric psychiatric consultation for a non-emergency hospital in-patient. This service is subject to the same conditions as billing code <billingCode>A795</billingCode>.—
- C695Neurodevelopmental ConsultationA neurodevelopmental consultation for a non-emergency hospital in-patient, rendered by a psychiatrist. This service is subject to the same conditions as <billingCode>A695</billingCode>.—
- C395Limited consultationA limited consultation by a psychiatrist for a non-emergency hospital in-patient. It is a less demanding consultation but follows the same requirements as a full consultation, including a written request from a referring practitioner.—
Psychotherapy & psychiatric care — in-patient
- K190Individual in-patient psychotherapyThis service is for individual psychotherapy provided to a hospital in-patient by a psychiatrist. Payment is calculated based on time units, where one unit represents a half-hour or major part thereof.—
- K199Psychiatric care - in-patientA time-based service for in-patient psychiatric care, defined as any form of assessment and treatment for mental illness, behavioural maladaptations, or other emotional problems, considering the patient's biological and psychosocial functioning.—
- K191Family psychiatric care - in-patientProvides payment per half-hour unit for family psychiatric care for an in-patient, involving assessment and treatment for mental illness in the presence of family members or other caregivers.—
- K193Family psychotherapy - in-patients (two or more members)Family psychotherapy for an in-patient with two or more members present, billed per half-hour unit. This service is for the treatment of mental illness or behavioural maladaptations in a hospital setting.—
- K194Hypnotherapy - Group - for induction and training for hypnosis - per member (maximum eight people)Group hypnotherapy for induction and training for hypnosis. This service is billed per member for groups up to a maximum of eight people and is calculated in time units.—
Group psychotherapy — in-patient
- K200Group psychotherapy, in-patients - 4 people - per unitA time-based service for providing group psychotherapy to 4 in-patients, billed per member, per unit (approximately 30 minutes). Limited to the first 12 units per patient per day.—
- K201Group psychotherapy, in-patients - 5 people - per member - first 12 units per dayFee for one unit of in-patient group psychotherapy for a single member of a 5-person group. This fee applies to the first 12 units of the session per day.—
- K202Group psychotherapy, in-patients - 6 to 12 people - per member - per unitA service for in-patient group psychotherapy provided to a group of 6 to 12 members. This fee is claimed per member for each half-hour unit of service, for the first 12 units per day.—
- K207Group psychotherapy, in-patients - additional units - per member (maximum 6 per patient per day)Payable for each additional unit of group psychotherapy for an in-patient, after the first 12 units per day, per member. This code is limited to a maximum of 6 additional units per patient per day.—
- K211Group psychotherapy, in-patients - 3 people - per unitA unit-based fee for providing group psychotherapy to an in-patient as part of a group of three people, billed per member. A unit is defined as ½ hour or a major part thereof, with a maximum of 12 units billable per day for this service.—
Mental Health Act forms & certification
- K623Application for psychiatric assessmentA psychiatric assessment for the purpose of completing a Form 1 application under the *Mental Health Act*. This service includes the necessary history, examination, and required notifications.$133.60
- K624Certification of involuntary admissionCertification of involuntary admission (Form 3) in accordance with the *Mental Health Act* includes necessary history, examination, notification of the patient, family and relevant authorities and completion of form.$164.50
- K629Re-certification of involuntary admissionA psychiatric assessment for the re-certification of a patient's involuntary admission under the Mental Health Act, which includes the necessary history, examination, and completion of all appropriate forms.$48.75
- K620Consultation for involuntary psychiatric treatmentA time-based consultation for involuntary psychiatric treatment as per the Mental Health Act, billed in half-hour units. This service requires a referral and includes the necessary history, examination, and completion of relevant forms.—
- K630Psychiatric consultation extensionA time-based extension for specific psychiatric consultations, payable in units of 30 minutes or major part thereof, for additional time spent with the patient or their representative on the same day. The fee is $117.40 per unit.—
Electroconvulsive therapy
- G478Electroconvulsive therapy (ECT) cerebralPerformance of single or multiple applications of electroconvulsive therapy (ECT) for a cerebral condition on an in-patient basis.$102.35
- G479Electroconvulsive therapy (ECT) cerebral - single or multiple - out-patientCovers a single or multiple session(s) of cerebral electroconvulsive therapy (ECT) for a patient in an out-patient setting. It is distinct from <billingCode>G478</billingCode> which is for in-patients.$118.00
Neurocognitive assessment
Long-term care
- W190Special psychiatric consultationA special psychiatric consultation for a patient in a non-emergency long-term care institution. This service is subject to the same conditions as <billingCode>A190</billingCode>, requires a written referral and a report to the referring practitioner, and likely has a minimum time requirement.—
- W196Repeat consultationA repeat psychiatric consultation for a non-emergency in-patient in a long-term care facility. This service is for an additional consultation by the same psychiatrist for the same problem, rendered after the patient has received care from another physician, and requires a new written referral.—
- W395Limited consultationA limited consultation rendered by a psychiatrist for a patient in a non-emergency long-term care setting. This service is less demanding and requires less time than a full consultation but must meet all other requirements for a consultation as defined in the Schedule of Benefits.—
- W795Geriatric psychiatric consultationA geriatric psychiatric consultation for a non-emergency in-patient in a long-term care institution. This service is subject to the same conditions as general listing consultation <billingCode>A795</billingCode>.—
- W895Psychiatric Consultation - Non-Emergency Long-Term Care In-PatientA psychiatric consultation for a patient in a non-emergency, long-term care in-patient setting, following a written request from a referring practitioner.—
- W695Neurodevelopmental consultationA neurodevelopmental consultation for a non-emergency in-patient in a long-term care institution. This service is subject to the same conditions as the general listing code <billingCode>A695</billingCode>.—
How to use this psychiatry code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to psychiatry (specialty 19) — 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 psychiatry 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 psychiatry bill?
The consultations & assessments — office section of this set starts with A195 (Psychiatric Consultation). 13 codes are listed in that section.
What is in the Psychiatry code set?
62 OHIP billing codes across 11 sections: Consultations & assessments — office; Psychotherapy & psychiatric care — out-patient; Group psychotherapy — out-patient; Hospital in-patient consultations & visits; Psychotherapy & psychiatric care — in-patient; Group psychotherapy — in-patient; Mental Health Act forms & certification; Community care premiums; Electroconvulsive therapy; Neurocognitive assessment; Long-term care. Psychiatric consultations, psychotherapy and psychiatric care by setting, group therapy, Mental Health Act forms, community care premiums and ECT.
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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