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Billing code

A191A — Consultative interview – caregiver of patient 65+ or with dementia

Psychiatric caregiver interview

A psychiatrist bills A191 for a consultative interview, with report, with the caregivers of a patient 65 or older or with dementia.

Watch for: It is a consultation, so put the referrer's billing number on the claim; virtually, it can be done by video only.

Code

A191A

Description

Consultative interview – caregiver of patient 65+ or with dementia

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Psychiatric consultative interview, with report, with the caregiver(s) of a patient, for a patient 65 or older or with dementia.

What it covers

A191 is a consultative interview on behalf of a disturbed patient, including a report, with the caregiver(s) of a patient who is at least 65, or under 65 with a diagnosis of dementia (A184).

A disturbed patient has a clinically significant disturbance in cognition, emotional regulation or behaviour that limits their ability to give a reliable and complete history. A191, A192, A197 and A198 are consultations (A184).

Billing rules

• Needs a written, signed request from a physician or nurse practitioner, kept in the chart, and a written report back, or it is paid as a lesser assessment (GP16).
• A191, A192, A197 and A198 are not payable for the same patient on the same day as K191, K193, K195 or K196 (A184).
• K630 extension units start after 60 minutes (76 minutes for the first unit to be paid); if A191 and A192 are both billed the same day, after 120 minutes (A185).
• Detention (K001) is not payable for the same patient on the same day (GP31).
• By video only (not phone) with an existing patient relationship; add K300A (Appendix J, A70).

Often billed with

• K630 psychiatric consultation extension (A185).
• K188 (+15%) within 6 months after a suicide attempt (A188).

Common rejections

• ARF: OHIP describes this as 'Missing Physician Referring Number'. A consultation is paid only on a written referral from a physician or nurse practitioner (GP16); enter the referrer's billing number.
• AT4: OHIP describes this as 'Modality Not Allowed': this code is on the video-only list, so it can't be billed with K301A (telephone) (Appendix J).

Related codes: A192, A197, A198, A195, K630, K188

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A184.

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