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Billing code

K050A — MCFSC HSR & ADL Amalgamated Form

ODSP initial application forms

Bill K050 for completing the Health Status Report and Activities of Daily Living Index together for an initial ODSP application.

Watch for: If only one part is completed, bill K051 or K052 instead; it's paid for the social services ministry, not OHIP-insured.

Code

K050A

Description

MCFSC HSR & ADL Amalgamated Form

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

Amalgamated Health Status Report and Activities of Daily Living Index for an initial ODSP application. Paid for MCCSS; not an OHIP insured service.

What it covers

K050 is the fee for completing the Health Status Report and the Activities of Daily Living Index together, as the amalgamated forms for a patient's initial Ontario Disability Support Program (ODSP) application (AF1).

Appendix F is not part of the Schedule of Benefits and is reproduced for information only. Its services are not insured services under the Health Insurance Act; the Ministry of Health pays them as paying agent for the Ministry of Children, Community and Social Services (MCCSS) (AF1).

Billing rules

• Bill K050 when both parts are completed together for an initial application. When only one part is completed, bill K051 (Health Status Report) or K052 (Activities of Daily Living Index) instead (AF1).
• The later ODSP Medical Review process has its own codes: K057 for Medical Form Part A, and K058, K059 or K060 for Part B (AF1).
• The MCCSS forms are given to patients only by social services staff. Each fee code is specific to its form and can't be claimed for completing any other government document (AF2).
• K050 isn't one of the codes the after-hours premium is paid on, so Q012A on the same claim doesn't add a premium to it (OMA Q-codes guide p.8; Agreement p.68 §8.12).
• FHO Income Stabilization physicians, whose services in the FHO otherwise pay $0 as globally funded, may bill K050A at full fee-for-service value (FHO agreement p.99, Appendix J §3.4–3.6).

Often billed with

• A007A intermediate assessment, when the patient is also assessed for a medical problem at the visit. Appendix F's same-day restriction applies only to the eye examinations K065 and K066, not to the ODSP and Ontario Works form codes (AF1, AF2).
• K053A Ontario Works Limitation to Participation form, when that separate MCCSS form is also completed; each code is specific to its own form (AF2).

Common rejections

• VJ7: OHIP received the claim more than three months after the service date, so it was rejected as stale-dated (GP9).

Related codes: K051, K052, K057, K058, K053, K054, K055

Source: Schedule of Benefits (July 1, 2026), Appendix F (information only; not insured services), MCSS Ontario Disability Support Program (ODSP), page AF1; MCCSS forms note, page AF2

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