What are the billing rules for K055A?

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 Pregnancy/Breast-feeding Nutritional Allowance has its own application and code, K056, and the Mandatory Special Necessities Benefit Request Form is K054 (AF1). K055 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).

What is K055A 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). K054A when the Mandatory Special Necessities Benefit Request Form is also completed; each code is specific to its own form (AF1, AF2).

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Billing code

K055A — MCFSC Special Diet Application Form

Q: What is OHIP billing code K055A?

Fee for completing the Application for Special Diet Allowance, an MCCSS form listed with the ODSP forms in Appendix F. Not an OHIP insured service.

Special diet allowance form

Bill K055 for completing the Application for Special Diet Allowance, paid for the social services ministry rather than OHIP.

Watch for: Only for this form; the pregnancy and breastfeeding nutritional allowance is K056, and Q012A adds no premium.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$23.20	$0.00	$0.00	$0.00	$0.00

Code: K055A
Description: MCFSC Special Diet Application 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 Application for Special Diet Allowance, an MCCSS form listed with the ODSP forms in Appendix F. Not an OHIP insured service.

What it covers

K055 is the fee for completing the Application for Special Diet Allowance, 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 Pregnancy/Breast-feeding Nutritional Allowance has its own application and code, K056, and the Mandatory Special Necessities Benefit Request Form is K054 (AF1).
K055 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 K055A 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).
K054A when the Mandatory Special Necessities Benefit Request Form is also completed; each code is specific to its own form (AF1, AF2).

Related codes: K054, 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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