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Billing code

K119A — Paediatric developmental assessment incentive (PDAI)

Paediatric developmental incentive

Bill K119 yearly when the paediatrician managing a child under 6 at developmental risk uses a screening tool three times in 12 months.

Watch for: Only for paediatricians and children under 6, after at least 3 visits in 12 months; one per year, six per lifetime.

Code

K119A

Description

Paediatric developmental assessment incentive (PDAI)

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

Yearly incentive for the paediatrician managing a child under 6 at developmental risk, using a screening tool three times in 12 months.

What it covers

PDAI is the service by the paediatrician most responsible for ongoing management of a child at developmental risk, using developmental surveillance and documenting the child's development indicators three times in 12 months (A170).

Billing rules

• Maximum one per patient per 12 months, and six per patient per lifetime (A170).
• Only for patients under 6 years of age (A170).
• You must have provided at least three consultations, assessments or visits to the patient in the preceding 12 months (A171). Comprehensive virtual visits count toward these (A75).
• Only payable to a specialist in Paediatrics (26) (A171).
• A standardized developmental screening tool must have been completed three times in the previous 12 months and kept in the chart (A171).
• Submit only after all required elements for the previous 12 months are done (A171).

Common rejections

• A2A: OHIP describes this as 'Outside of age limit': K119 is only for children under 6 (A170).
• A4D: OHIP describes this as 'Invalid specialty for this service code': K119 is only payable to Paediatrics (26) (A171).
• AM1: OHIP describes this as 'Service limit exceeded': more than one K119 in 12 months or six in a lifetime (A170).

Related codes: A262, A263, A264, K122, A268

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Paediatrics (26), page A170; payment rules A171.

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