< Billing codes

Billing code

K015A — Counselling of Relatives (scheduled visit)

Counselling a dying patient's family

Bill K015 per half-hour unit for counselling relatives of a catastrophically or terminally ill patient about treatment options or prognosis.

Watch for: Claim it under the ill patient's health number, pre-booked; it isn't payable with K023 palliative care support.

Code

K015A

Description

Counselling of Relatives (scheduled visit)

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

Counselling one or more relatives of a catastrophically or terminally ill patient about treatment options or prognosis, billed per half-hour unit.

What it covers

K015 is counselling given to a relative, relatives or representative of a catastrophically or terminally ill patient, to build their awareness of the treatment options for the patient and/or the prognosis (GP60).

It covers one or more persons in the same session (A21). The service is with the relatives, not the patient (GP54).

Billing rules

• Claim under the health number of the patient who is catastrophically or terminally ill (GP60).
• As a counselling service it must be pre-booked, or OHIP pays it as a lesser assessment (GP58; OMA palliative guide p.5).
• Only the services on the GP58 counselling list are payable with it the same day by you (for example E080, G372, K002, K003, K008, K014, K031, K730) (GP58).
• Not payable with K023 palliative care support, which excludes other Family Practice consultation and visit codes except A945/C945 (A2).
• 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 (Appendix J AJ1, A70).

Often billed with

• K002 interview with relatives or a substitute decision-maker, when that is a separate booked service (GP58, A28).
• FHO: K015 is an in-basket core service (FHO Agreement Schedule 2, p.79; Schedule 2A, p.85).

Common rejections

• VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
• EH2: The version code doesn't match OHIP's record; for K015 the claim uses the ill patient's health card, not the relative's (EH2 guide; GP60).
• R03: The province code on the claim is invalid or missing; check the patient's province and health number.
• AT3: Usually means it was billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person visit with you in the past 24 months (AT3 guide; A66).

Related codes: K013, K023, K002, A945, K014

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), Counselling, page A21; rules GP54–GP60.

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