1What Is the C190 OHIP Code?
C190 is an OHIP billing code used for special psychiatric consultations conducted in hospital in-patient settings. This code requires psychiatrists to spend a minimum of 75 minutes in direct contact with the patient, excluding time spent on unrelated services or non-patient-facing tasks. It is typically used in situations involving complex psychiatric assessments, such as a serious suicide attempt, first-episode psychosis, or diagnostically ambiguous presentations.
It is vital to note that time spent outside of direct patient contact, such as reviewing charts or engaging in collateral discussions, does not count towards the 75-minute requirement. This specificity often leads to the code being improperly billed, highlighting the importance of accurate documentation.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A190 | Special psychiatric consultation | As applicable to outpatient settings | Equivalent service for outpatients. |
| A195 | Consultation | Where more limited consultation is appropriate | Standard psychiatric consultation. |
| A196 | Repeat consultation | As required | Subsequent consultation for the same patient. |
| A395 | Limited consultation | As required | Consultation of limited scope or necessity. |
3Eligibility Requirements
- Virtual Delivery: C190 can be rendered virtually via video only, billing under C190A. Telephone consultations are not covered.
- Frequency Limitations:
- One service per two consecutive 12-month periods for the same patient, physician, and diagnosis.
- Two services per two consecutive 12-month periods allowed if the second occurs as a hospital in-patient or ED visit more than 12 but less than 24 months after the first.
- Clearly defined unrelated diagnosis: one service every 12 months.
- Ineligibility for Neurodevelopmental Conditions: Lesser fees apply for conditions like ADHD and other less complex disorders.
4What Your Clinical Note Must Show
Ensure documentation clearly indicates at least 75 minutes of direct patient involvement.
- List start and end time of direct contact
- Exclude non-direct activities like chart review.
5Weak vs. Strong Note Examples
The strong note specifies the start and end times of direct patient contact and clearly separates non-contact activities; the weak note lacks detail and fails to verify the required time spent.
Patient seen for assessment. Complex case discussed. Symptoms reviewed.
Encounter lasted for 75 minutes of direct communication with the patient.
The session involved comprehensive assessment for diagnostic clarification.
- Start time: 09:00 AM
- End time: 10:15 AM
- Excluded non-patient contact activities documented separately.
