Billing code
K004A — Psychotherapy - Family (2 Or More Family Members In Attendance At The Same Time) Per Unit
Family psychotherapy
Bill K004 per half-hour unit for psychotherapy with 2 or more family members present at the same time.
Watch for: Outside hospital, an assessment by you the same day isn't payable unless the diagnoses are clearly different; record start and stop times.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $86.85 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- K004A
- Description
- Psychotherapy - Family (2 Or More Family Members In Attendance At The Same Time) Per Unit
- 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
Family psychotherapy with 2 or more family members present, per half-hour unit. Outside hospital, no same-day assessment unless the diagnoses differ.
What it covers
Psychotherapy is treatment of mental illness, behavioural maladaptations or other problems assumed to be emotional, where the physician deliberately establishes a professional relationship to remove, modify or retard symptoms and promote positive personality growth. Family psychotherapy is psychotherapy given to the patient in the presence of one or more members of the patient's household (GP56).
K004 is the family listing: 2 or more family members in attendance at the same time (A24). Psychotherapy includes narcoanalysis, psychoanalysis and treatment of sexual dysfunction (A24), and the service includes the history, brief exam, arranging tests and follow-up, and advice about the service (GP54).
Billing rules
- Outside hospital, not payable with a consultation or other assessment by you during the same visit or the same day unless there are clearly defined different diagnoses for the two services (A24, GP55).
- Not payable on the same day as an obstetrical delivery by you to the same patient (GP56).
- Units are ½ hour or major part: 1 unit = at least 20 minutes, 2 units = 46, 3 units = 76, 4 units = 106, then every 30 minutes more, counted on consecutive time in direct contact with the physician (GP54, GP55).
- Record start and stop times in the chart, or the service is not eligible for payment (GP7).
- Under 20 minutes is not psychotherapy; bill the assessment you actually provided (GP55).
- K004 is a qualifying service for the focused practice psychotherapy premium; eligible physicians are paid 17% more automatically (GP56, GP57).
- May be given by video or phone as comprehensive virtual care with K300A or K301A; by phone it pays 85% of the in-person fee (AJ1, A70).
- FHO: in basket (Agreement Schedule 2, p.79; Schedule 2A, p.85), but not one of the codes that earn the after-hours premium (Agreement p.68, §8.12).
Often billed with
- K300A or K301A modality indicator when the session is by video or phone (A70).
- E080 first visit after hospital discharge, office or home, within 2 weeks of an acute in-patient discharge (GP28).
Related codes: K007, K005, K006, K019, K012, K010, K013, E080
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), Psychotherapy, page A24; rules GP54–GP57.
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