Case Conferences for Psychiatrists

When you sit down to meet with 2 other health care professionals, including the physician most responsible for the patient, you’re eligible to bill case conference units through OHIP. The two other eligible health professionals can be a combination of: other physicians, social workers, or regulated health professionals (participant requirements differ for each code).  The purpose of these conferences, lasting anywhere from 10 – 80 minutes and billed by time units, is to discuss treatment plans and care of the patient in question.

What’s really great about these conferences is that they can take place the old-fashioned way, around a table in person… or via videoconference or telephone. Though it’s not required, you have the option of using OTN (Ontario TeleMedicine Network) to videoconference securely, and can still bill through OHIP with your other claims… plus you get the OTN premium.

As you’ll see below, the MOH has broken down case conferences into categories depending on specialty, medical setting (inpatient/outpatient), and age.  We focus here on those conferences relevant to Psychiatrists.

Mental Health Case Conferences

K701 ($31.35/unit) – Mental Health Case Conference

This case conference is limited to the Psychiatric specialty only. The requirements for mental health case conferences are as follows:

• Pre-scheduled meeting
• Can take place in person, via videoconference or by telephone
• 3 participants: MRP specialist in Psychiatry, other physicians or social workers, regulated health professionals or community mental health personnel employed by MOHLTC
• Purpose is to manage patient treatment, not transfer of care
• Only applicable for adult patients
• Maximum 8 units per patient per day, maximum 4 K701s per patient per year
• Not payable with telephone conferences the same day

K704 ($31.35/unit) – Paediatric Out-Patient Case Conference

All the same requirements as above, except:

• Applicable for patients less than 18 years of age
• 3 participants: MRP with specialty in Psychiatry or Paediatrics, other physicians, social workers, regulated health professionals or personnel from accredited centres of Children’s Mental Health Ontario

K121 ($31.35/unit) – Hospital In-Patient Case Conference

The inpatient case conference can be billed by physicians of any specialty. This code is payable with in-patient treatment codes and subsequent visits.

• Pre-scheduled meeting
• Can take place in person, via videoconference or by telephone
• 3 participants: MRP, other physicians or social workers, regulated health professionals
• Purpose is to manage patient treatment, not transfer of care or rounds
• Maximum 8 units per patient per day, maximum of four K701s per patient, per year
• Not payable with telephone conferences the same day

Time units for case conferences

Need to know more? Just request a blog, and we’ll post the answers to your billing questions!