1What Is the K630 OHIP Code?
K630 is an OHIP billing code for the extension of psychiatric consultations in Ontario. It is utilized when a standard consultation surpasses its allocated time, typically due to cases involving complex trauma histories, collateral interviews, or extensive risk assessments. Each unit represents an additional half-hour or the major part thereof spent with the patient.
This code is commonly used in situations where the initial consultation cannot be rushed, ensuring the psychiatrist has adequate time to address intricate details of a patient's condition. However, it's crucial to meet the base consultation time requirements before billing K630. For instance, an A195 requires 76 minutes for one K630 unit and 106 minutes for two units.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A190 | Special psychiatric consultation | One service per 12-month period | $342.25; Requires 90 minutes, extensions beyond 106 minutes billable. |
| A195 | Consultation | Once per patient, unless clinically justified | $254.30; 60-minute minimum, extendable beyond 76 minutes with K630. |
| A196 | Repeat consultation | When follow-up consultation is warranted | $120.30; Requires justification for repeat assessments. |
| A395 | Limited consultation | As clinically necessary | $120.30; Used for focused or initial assessments. |
3Eligibility Requirements
To be eligible to bill K630 under OHIP, the service must be a time-based extension to a psychiatric consultation. K630 can be billed after reaching minimum consultation times set for various base codes (e.g., minimum 76 minutes with A195). The eligibility allows up to six units per patient per day, with each unit representing an additional 30 minutes.
K630 is available for virtual services only through video conferencing, billed as K630A. It is not eligible for telephone consultations. Additionally, frequency requirements may restrict billing to one service per two consecutive 12-month periods, with exceptions for hospital inpatients or emergency department visits.
4What Your Clinical Note Must Show
Ensure precise documentation of time spent face-to-face with the patient. Exclude unbillable activities.
- Record the start and end time of each consultation extension.
- Ensure clear notation of patient engagement excluding non-contact activities like chart reviews.
5Weak vs. Strong Note Examples
The strong note succeeds because it specifies the base service duration, reasons for extension, and details the activities during the extended time. The weak note fails due to its lack of specifics.
Patient seen for an extended consultation. Discussed history and future treatment plan.
Initial 60-minute consultation completed for A195. Required 76 minutes total due to complex PTSD symptomatology accompanied by family history discussion.
Extended assessment included 1 additional K630 unit (30 minutes) for detailed risk assessment and patient stabilization planning.
- Clearly state the base service and its duration.
- Document specific reasons for extension beyond the initial consultation.
- Provide detailed descriptions of what was accomplished during the extension.
