1What Is the K190 OHIP Code?
What is K190?
K190 is an OHIP billing code used by psychiatrists for individual in-patient psychotherapy services rendered to hospital in-patients. This code is billed per unit of time, where each unit represents time spent directly with the patient.
This billing code is particularly useful for patients with severe depression who require frequent and intensive psychotherapy sessions during their hospital stay. Unlike some other billing codes, the time units for K190 can be accumulated over non-consecutive patient interactions within the same day.
Psychiatrists should ensure that the total time billed meets the minimum time requirements to avoid issues with claims. Services lasting less than 20 minutes do not qualify as K190 and should be billed under a different assessment code.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A190 | Special psychiatric consultation | Once per patient per 12 months | Consultation for complex psychiatric cases. |
| A195 | Consultation | Typically once per patient unless new issue arises | Standard psychiatric consultation. |
| A196 | Repeat consultation | As required for ongoing care | Follow-up consultations after initial assessment. |
| A395 | Limited consultation | As determined necessary | More focused on specific issue. |
3Eligibility Requirements
Eligibility Requirements for K190
- Minimum Time Requirement: The first billing unit requires at least 20 minutes of direct patient contact, with each additional unit needing 30 more minutes.
- Non-Consecutive Time: For in-patient psychotherapy, time does not need to be consecutive and can be accumulated over different sessions throughout the day.
- Same-Day Exclusions: K190 cannot be billed on the same day with a consultation or assessment for the same diagnosis unless different diagnoses are clearly documented.
- Ineligible Circumstances: Subsequent visits for psychotherapy on the same day are not billable if under 20 minutes or combined with other assessments, unless as specified in the rules.
- General Restrictions: Cannot coincide with obstetrical delivery or services outside the hospital on the same day.
4What Your Clinical Note Must Show
Ensure all sessions are accurately timed and documented.
- Record start and end times of each patient interaction.
- Detail therapeutic methods and patient's response.
- Include date and location of service rendered.
Document all relevant diagnoses for which psychotherapy is provided.
- Specify different diagnoses if K190 is billed with another service.
- Update diagnostic information as patient condition evolves.
5Weak vs. Strong Note Examples
The strong note succeeds due to its specific documentation of time and therapeutic activities provided during each session, unlike the weak note which lacks detail and timing.
Patient seen today for psychotherapy.
Session duration not specified.
Patient presented with symptoms consistent with major depressive disorder, requiring psychotherapy session.
- Session 1: 10:00 AM - 10:30 AM, cognitive behavioral therapy on coping mechanisms.
- Session 2: 2:00 PM - 2:46 PM, focused on anxiety management strategies.
