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Billing code

K002A — Interview with relatives or authorized decision-maker

Interview with relatives or decision-maker

Bill K002 per half-hour unit for an interview with the patient's relatives or Health Care Consent Act decision-maker, under the patient's health number.

Watch for: Not payable when solely to obtain consent; it must be a separately booked appointment of at least 20 minutes.

Code

K002A

Description

Interview with relatives or authorized decision-maker

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Interview with relatives or the patient's Health Care Consent Act decision-maker, per half-hour unit. Not payable when solely to obtain consent.

What it covers

K002 is an interview with the patient's relatives, or with a person authorized to make treatment decisions for the patient under the Health Care Consent Act (A28).

It covers obtaining information from, discussing with, and advising the interviewee about the patient's condition and care (GP61). It applies when medically necessary information can't be obtained from or given to the patient, for example because of illness or incompetence (A28). Any specialty may bill interviews (GP9).

Billing rules

• Only payable if the physician can show the interview was not solely to obtain consent. Claim it under the patient's health number and diagnosis (A28).
• Must be a separately booked appointment of at least 20 minutes; if it isn't separately booked, it is paid at a lesser fee (A28, GP61).
• Not payable when the information gathered is part of the history normally taken in a consultation or assessment (A28, GP61).
• Units are half-hours or major part: 1 unit = at least 20 minutes, 2 = 46, 3 = 76, 4 = 106, then every 30 minutes more, counting direct contact time (GP61). Record start and stop times in the chart, or the service is not eligible for payment (GP7).
• Must be rendered personally by the physician, or it is uninsured (GP61).
• Can be done by video or phone with an existing relationship; add K300A or K301A, and telephone pays 85% (AJ1, A70).
• FHO: K002A is an in-basket core service (Agreement Schedule 2, p.79). It is not on the list of codes that earn the Q012A after-hours premium (Agreement p.68).

Often billed with

• K301A or K300A modality indicator when the interview is by phone or video (A70).
• Counselling (K013, K033) by the same physician the same day: K002 is on the GP58 list of services payable with counselling (GP58).
• K045 or K046 diabetes management by a specialist: K002 counts toward their 4 required services (A99, A100).

Common rejections

• AT3: Billed by video or phone (K300A/K301A), but OHIP found no existing relationship: no in-person service in 24 months and no enrolment to you or your group (A66). Otherwise bill A101/A102.

Related codes: K003, K008, K013, K015, K300, K301

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), Interviews, page A28; General Preamble GP61 (interviews) and GP7

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