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Billing code

K195A — Family psychotherapy – out-patient

Out-patient family psychotherapy

Bill K195 per half-hour unit for family psychotherapy with an out-patient and two or more family members.

Watch for: Claim it under the patient's health number; a same-day assessment by you needs a clearly different diagnosis.

Code

K195A

Description

Family psychotherapy – out-patient

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

Family psychotherapy for an out-patient with two or more family members, per half-hour unit.

What it covers

Psychotherapy is treatment for mental illness, behavioural maladaptations or emotional problems where the physician deliberately builds a professional relationship to remove, modify or slow symptoms and promote personal growth. Family psychotherapy is done in the presence of one or more members of the patient's household (GP56).

K195 is the out-patient listing for two or more members; in-patient is K193 (A190).

Billing rules

• Billed in ½-hour units: 1 unit = at least 20 minutes, 2 = 46, 3 = 76, 4 = 106, then every 30 minutes more; count only direct contact time, excluding other separately billed services (GP54–GP55).
• Time must be consecutive (only in-patient individual psychotherapy and in-patient individual psychiatric care may add up non-consecutive time) (GP55).
• Record start and stop times in the chart, or the service is not payable (GP7).
• Claim against the patient's health number and diagnosis (A190).
• Not payable the same day as a consultation or assessment by you for the same patient, unless the two have clearly different diagnoses (GP55).
• Not payable the same day as an obstetrical delivery by you for the same patient (GP56).
• A191, A192, A197 and A198 are not payable for the same patient on the same day as K191, K193, K195 or K196 (A184).
• Can be done by video or phone with an existing relationship; add K300A or K301A (Appendix J, A70).

Often billed with

• K187 (+15%) within 4 weeks after discharge from a hospital stay for a psychiatric condition (A188).
• K188 (+15%) within 6 months after a suicide attempt (A188).

Common rejections

• AT3: Billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person service by you in the past 24 months (A66).

Related codes: K193, K196, K197, K198, K187, K188

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Psychiatry (19), page A190; rules GP54–GP56.

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