OHIP billing code for ADHD
Updated October 26, 2026
There's no single OHIP fee code for ADHD. Bill the visit you provide, usually A007A (intermediate assessment), K005A (primary mental health care) or K013A (counselling) for 20 minutes or more, with diagnostic code 314, attention deficit disorder and ADHD.
| Code | What it is | Fee | When to bill it |
|---|---|---|---|
| A007A | Intermediate assessment | $44.55 | Routine ADHD follow-up and medication review. |
| K005A | Primary mental health care, per unit | $80.00 | Assessment and treatment of the patient's mental or behavioural problem, 20 minutes or more per unit. |
| K013A | Individual counselling, per unit (first 3 units a year) | $80.00 | A pre-booked visit dedicated to counselling, 20 minutes or more. Later units in the 12 months are K033A ($56.30). |
| K008A | Diagnostic interview or counselling with child and/or parent, per unit | $80.00 | A booked interview with a child and/or parent about a psychological problem or learning disability, under the child's health number. |
| K002A | Interview with relatives, per unit | $80.00 | A booked interview with relatives or a substitute decision-maker when information can't be obtained from or given to the patient. |
How to bill it
Under 20 minutes, bill the assessment you did (A001A or A007A). At 20 minutes or more, K005A or K013A per half-hour unit: 1 unit at 20 minutes, 2 at 46, 3 at 76 (GP55).
Record start and stop times for every time-based code, or it isn't payable (GP7).
Use diagnostic code 314 on the claim.
For a child, a separate booked interview with the parent can be billed as K008A under the child's health number (A28).
Billing rules
- K005 isn't payable the same day as a consultation or other assessment by you unless the diagnoses are clearly different (GP55, A21).
- K013 must be pre-booked; the same day you can only bill services on the counselling list (GP58), not an assessment.
- K013 covers the first 3 units of K013/K040 per patient per physician per 12 months; then K033 (A21).
- Psychological testing isn't an insured service (A28).
- A prescription renewal requested without a visit is uninsured (OMA uninsured services guide).
- K005, K007, K008 and K013 can be done by video or phone with an existing relationship; by phone, K005 and K007 pay 95% (A70, AJ1).
- FHO: K005, K007, K008 and K013 are in-basket core services; K033 isn't (Agreement Schedule 2, p.79).
Diagnostic codes
- 314: Attention deficit disorder and attention deficit hyperactivity disorder
Common rejections
- CNA: OHIP's description is 'counselling not allowed'. Another service you billed that day isn't on the counselling same-day list (GP58).
- AT3: Billed as comprehensive virtual care (K300A or K301A), but OHIP found no existing patient-physician relationship: no in-person insured service with you in the past 24 months and no enrolment to you or your group (A66). Otherwise bill limited virtual care, A101A or A102A.
Questions
What is the OHIP billing code for ADHD?
There's no single OHIP fee code for ADHD. Bill the visit you provide, usually A007A (intermediate assessment), K005A (primary mental health care) or K013A (counselling) for 20 minutes or more, with diagnostic code 314, attention deficit disorder and ADHD.
What is the OHIP diagnostic code for ADHD?
314, attention deficit disorder and attention deficit hyperactivity disorder (Ministry diagnostic code list).
Can I bill OHIP for ADHD school or insurance forms?
No. Forms for schools, employers or insurers are uninsured and billed to whoever asks for them (OMA uninsured services guide).
Related: OHIP billing code for bipolar disorder · OHIP billing code for cognitive assessment · OHIP billing code for phone visit · OHIP billing code for family meeting
Sources
- Schedule of Benefits: Physician Services (July 1, 2026)
- Ministry of Health: Diagnostic Codes (2026)
- OMA: Physician's Guide to Uninsured Services (January 2024)
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