Billing code
K033A — Counselling - When billing more than 3 units/yr (K013)
Individual counselling, after 3 units
Bill K033 per half-hour unit for pre-booked counselling after the patient has had 3 units of K013/K040 from you in 12 months.
Watch for: A same-day assessment isn't payable; only services on the counselling same-day list can be billed with it.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $56.30 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- K033A
- Description
- Counselling - When billing more than 3 units/yr (K013)
- 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
Individual counselling units beyond the first 3 (K013/K040) per patient per physician in 12 months, billed per half-hour unit at a lower fee.
What it covers
K033 is the same individual counselling service as K013: a pre-booked visit dedicated solely to an educational dialogue about the patient's problem, its prevention and treatment (GP58).
It applies once the patient has had 3 units of K013 and K040 combined from you in the 12-month period (A21).
Billing rules
- Bill K033 for counselling units after the first 3 units of K013/K040 combined per patient per physician per 12 months; OHIP adjusts excess K013 units to the K033 fee (A21, GP58).
- The visit must be pre-booked, or it is paid as a lesser assessment (GP58).
- Only services on the GP58 same-day list are payable with counselling the same day (for example E080, G365, G372, G538, G590, K002, K003, K008, K014, K015, K031, K035, K036, K038, K682–K684, K730) (GP58).
- 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
- E080 first visit after hospital discharge (GP28).
- K300A or K301A modality indicator for virtual visits (A70).
- FHO: Q012A after-hours premium for enrolled patients (FHO Agreement p.68, §8.12).
Common rejections
- CNA: OHIP's 'counselling not allowed' rejection; check whether another service billed by you that day falls outside the GP58 same-day list (GP58).
- EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).
- V22: The diagnostic code isn't a valid OHIP code, often a four-digit code where the three-digit one is needed (V22 guide).
- 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).
- A3H: More services were billed on the line than OHIP allows for this code; check the limit and how units are counted (A3H guide).
Related codes: K013, K040, K041, K005, K007
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Family Practice & Practice in General (00), page A21; rules GP54–GP59.
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