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Billing code

K054A — MCFSC Mandatory Special Necessities Benefit Form

Special necessities benefit form

Bill K054 for completing the Mandatory Special Necessities Benefit Request Form, paid for the social services ministry rather than OHIP.

Watch for: Only for this form; the special diet and pregnancy nutrition forms are K055 and K056.

Code

K054A

Description

MCFSC Mandatory Special Necessities Benefit 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

Fee for completing the Mandatory Special Necessities Benefit Request Form, listed with the ODSP forms in Appendix F. Not an OHIP insured service.

What it covers

K054 is the fee for completing the Mandatory Special Necessities Benefit Request Form, listed under the ODSP heading of Appendix F (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

• 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).
• The other allowance forms in the same list have their own codes: K055 for the Application for Special Diet Allowance and K056 for the Pregnancy/Breast-feeding Nutritional Allowance (AF1).
• K054 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 K054A 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).
• K055A when the patient's Special Diet Allowance application is also completed; each code is specific to its own form (AF1, AF2).

Related codes: K055, K056, K050, K053

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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