< Billing codes

Billing code

K007A — GP Psychotherapy

Individual psychotherapy

Bill K007 per half-hour unit for individual psychotherapy; any specialty may bill it, in person or by video or phone.

Watch for: Record start and stop times; under 20 minutes isn't psychotherapy, and a same-day assessment needs a clearly different diagnosis.

Code

K007A

Description

GP Psychotherapy

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

Individual psychotherapy by a family physician (or any specialty), billed per half-hour unit.

What it covers

Psychotherapy is treatment for mental illness, behavioural maladaptations or other problems assumed to be emotional, where the physician deliberately builds a professional relationship with the patient to remove, modify or retard symptoms, reverse disturbed patterns of behaviour and promote positive personality growth (GP56).

It includes narcoanalysis, psychoanalysis and treatment of sexual dysfunction (A24). Any specialty may bill psychotherapy codes (GP9).

Billing rules

• Psychotherapy outside hospital is not payable the same day as a consultation or other assessment by you to the same patient unless the diagnoses are clearly different (GP55, A24).
• Not payable the same day as an obstetrical delivery by you for 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 (GP55).
• Count consecutive time in direct contact with the physician in person, excluding other separately billed services and chart work (GP54, GP55).
• Record start and stop times in the chart, or the service is not eligible for payment (GP7).
• Under 20 minutes is not this service; bill the assessment you actually provided (GP55).
• May be given by video or phone as comprehensive virtual care; add K300A or K301A. By phone it pays 95% of the in-person fee (A70, Appendix J AJ1).
• If a medical trainee provides it, at most 2 units are payable to the supervising physician (GP82).
• Physicians whose psychotherapy services made up more than half of their payments in the prior fiscal year get an automatic 17% focused practice premium on K007 for 12 months (GP56–GP57).

Often billed with

• E079 smoking cessation initial discussion (A56).
• E080 first visit after hospital discharge (GP28).
• K300A or K301A modality indicator for virtual visits (A70).
• FHO: K007 is an in-basket core service (FHO Agreement Schedule 2, p.79).

Common rejections

• EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).

Related codes: K004, K005, K006, K019, K020, K012, K024, K025, K010, K013

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), Psychotherapy, page A24; rules GP54–GP57.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing