Psychiatry bills time in units. The core codes are psychiatric care (K198A outpatient, K199A inpatient), individual psychotherapy (K197A) and family psychiatric care (K196A), with consultation codes at the front end. Virtual encounters additionally need a modality indicator — K300A for video, K301A for telephone — which carries no fee but which the Schedule requires on the claim.
IntelAGENT shows cumulative units per patient as you bill, so an annual limit is something you see coming. See how →
Compared with most specialties, psychiatry's code set is small and stable. What makes it error-prone is the unit arithmetic, the annual limits, and the virtual-care rules that changed the shape of the specialty's billing and have not stopped moving since.
The codes and what they pay
| Code | Description | Fee |
|---|---|---|
| A895A | Consultation with special visit | $297.00 |
| A198A | Consultation | $271.35 |
| A197A | Consultation | $271.35 |
| A195A | Consultation | $254.30 |
| K630A | Neurodevelopmental consultation | $134.00 |
| K199A | Psychiatric care, inpatient | $118.00 |
| K196A | Family psychiatric care, outpatient | $116.15 |
| K198A | Psychiatric care, outpatient | $102.35 |
| K197A | Individual outpatient psychotherapy | $102.35 |
| A194A | Partial assessment | $47.05 |
| K205A | Group psychotherapy, six to twelve people | $18.45 |
| K188A | High-risk community psychiatric care premium | add 15% |
| K300A | Modality indicator — video | no fee |
| K301A | Modality indicator — telephone | no fee |
Fees are from the OHIP Schedule of Benefits and are the ministry's, not ours. Unit limits, annual maximums and the eligibility conditions for each code are in the current Schedule — check them there, since they are the part that determines whether a claim pays. These fees are from the Schedule effective July 1, 2026 (PDF).
Virtual care tracking codes
K300A and K301A carry no fee. They exist so the ministry can distinguish a video encounter from a telephone one, and they accompany the service code rather than replacing it. Claim the in-person fee either way: the Schedule says telephone services are reduced automatically, so you do not reduce them yourself.
Three things to know:
- The tracking code is not optional. A virtual encounter submitted without one is liable to reject, and the explanatory code will not say "you forgot the tracking code" in those words.
- Video and telephone are different codes. Submitting K300A for a phone call is a misstatement of the service, not a shortcut.
- A nil line on the indicator is not a failure. The indicator was never going to pay on its own; the money is on the service line — see reading a Remittance Advice.
Virtual care rules have changed repeatedly. Which services may be delivered virtually, at what fee, and under what conditions have all been amended more than once. Do not rely on a remembered rule or on a page like this one for the current position — check the Schedule and the ministry's bulletins.
Units and limits
The psychotherapy and psychiatric care codes are unit-based: each unit represents a defined period of time, and the number of units claimed has to be supported by the documented duration of the session. On top of that sit limits — per patient, per time period, and in some cases annual maximums per physician.
The limits are the distinguishing feature of psychiatric billing. A rejection in this specialty is more often "you have exceeded a limit" than "this code is wrong", and the limit may have been reached weeks earlier by a different claim. That makes it very hard to diagnose from a single rejected line.
What helps:
- Tracking cumulative units per patient as you bill, rather than discovering the limit from a rejection.
- Reading the explanatory code carefully — the limit codes are distinct from the eligibility codes. Claim rejections explained.
- Keeping session start and end times in the record, because that is what supports the units if the claim is ever reviewed.
Group psychotherapy
Group psychotherapy codes are banded by group size, and the fee is per person in the group. K205A covers groups of six to twelve; other codes cover other bands. Billing the wrong band for the number of people present is straightforwardly a wrong claim, and the number present is something only you know — so the system cannot catch it for you, and the record has to say.
What gets missed
-
Family psychiatric care billed as individual care
K196A exists for family psychiatric care and is a different fee from K198A. Sessions involving family members are routinely billed as if they were individual.
-
The high-risk community premium
K188A adds 15% to the community psychiatric care code it attaches to, for high-risk patients. Because it is a percentage rather than a listed dollar amount, it is easy to overlook and hard to notice missing.
-
Units under-claimed on long sessions
A session that ran long supports more units. Billing a standard number out of habit is a silent loss.
-
Special visit premiums on after-hours and on-call work
Psychiatric emergencies attended outside regular hours may support a special visit premium — how they work.
Billing psychiatry in IntelAGENT
Psychiatry is billed in units against annual limits, and a limit you cannot see coming is a limit you find out about from a rejection.
- Unit tracking per patient. Cumulative units are visible as you bill, so a limit is something you see coming rather than learn from a rejection.
- Virtual tracking codes added with the service. Choosing video or telephone attaches the right tracking code rather than leaving it to memory.
- Percentage premiums and modality indicators read as settled. Codes that adjudicated correctly read as correct, rather than as unpaid lines to chase.
- Repeat-patient billing. Ongoing psychotherapy is largely the same claim every week — previous codes can be reused rather than re-entered, see the web portal.
- Rejections with the reason attached. Limit rejections are the hardest to interpret from a raw RA, so the explanatory code is translated — claim rejections.
Three months free, then 0.25% of paid claims, capped at $39.99 a month. IntelAGENT has submitted OHIP claims since 2016 for more than 2,000 Ontario physicians.
Frequently asked questions
Which OHIP codes do psychiatrists bill most?
Psychiatric care codes K198A outpatient and K199A inpatient, individual outpatient psychotherapy K197A, family psychiatric care K196A, the consultation codes A195A and A198A, and the virtual care tracking codes K300A and K301A.
What are K300A and K301A?
The Schedule calls them modality indicators — K300A for video, K301A for telephone (audio only). They carry no fee of their own and accompany the service code, and the Schedule requires one on every claim for a Comprehensive Virtual Care Service.
How are psychotherapy units billed?
Psychotherapy and psychiatric care codes are unit-based, with each unit representing a defined period of time and annual or per-patient limits set out in the Schedule. The documented time is what supports the units, and exceeding a limit is a rejection rather than a reduction.
How is group psychotherapy billed?
Group psychotherapy has its own codes banded by the number of people in the group — K205A covers groups of six to twelve, with other codes for smaller and larger groups. The fee is per person, which is why the code depends on the band.
Related reading
Why claims get rejected
Including the limit-based explanatory codes.
GuideReading a Remittance Advice
What a nil line on a premium or indicator actually means.
SpecialtiesAll specialties
Billing patterns by specialty.
ProductThe IntelAGENT web portal
Unit totals, repeat billing and settled positions in one place.