OHIP billing code for bipolar disorder

Updated October 26, 2026

Bill the visit you provide, usually K005A primary mental health care or K007A psychotherapy ($80.00 per half-hour unit) or A007A, with diagnostic code 296 (mood disorders, including bipolar affective disorder). FHO, FHN and other listed models add the tracking code Q020A for enrolled patients to count toward the serious mental illness premium.

Code	What it is	Fee	When to bill it
K005A	Primary mental health care, per unit	$80.00	Assessment and treatment of the mood disorder, 20 minutes or more per unit.
K007A	Individual psychotherapy, per unit	$80.00	Psychotherapy, 20 minutes or more per unit.
A007A	Intermediate assessment	$44.55	Shorter follow-up and medication review.
Q020A	Serious mental illness tracking code, bipolar disorder		On claims for enrolled patients with bipolar disorder, in the listed enrolment models. Counts toward an annual premium.

How to bill it

Under 20 minutes, bill the assessment (A001A or A007A). At 20 minutes or more, bill K005A or K007A per half-hour unit (1 unit at 20 minutes, 2 at 46, 3 at 76), with start and stop times charted (GP7, GP55).

Use diagnostic code 296 on the claim.

In FHO, FHN, FHG and the other listed models, add Q020A to the claim for an enrolled patient with bipolar disorder (AQ11; Agreement p.68 §8.11).

Billing rules

K005 or K007 outside hospital aren't payable the same day as a consultation or other assessment by you unless the diagnoses are clearly different (GP55, A21, A24).
K005 and K007 can be done by video or phone with an existing relationship; by phone they pay 95% (A70, AJ1).
FHO serious mental illness premium: $1,200 for at least 5 enrolled patients with bipolar disorder (Q020A) or schizophrenia (Q021A), and another $1,200 at 10. The patient must be enrolled to the billing physician (Agreement p.68 §8.11).
Q020A is one of the tracking codes allowed on a virtual care claim with K300A or K301A (INFOBulletin 221204).
FHO: K005 and K007 are in-basket core services (Agreement Schedule 2, p.79).
If an involuntary assessment is needed, the Mental Health Act Form 1 is K623A ($133.60) (A24).

Diagnostic codes

296: Mood disorders (e.g. manic episode, bipolar affective disorder, depressive episode)

Common rejections

EPA: Q020A is limited to physicians in the listed enrolment models. OHIP doesn't show you approved to bill it under the billing number and group used.
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 bipolar disorder?

What is the OHIP diagnostic code for bipolar disorder?

296, mood disorders, which includes bipolar affective disorder, manic episodes and depressive episodes (Ministry diagnostic code list).

Does Q020A pay anything on the claim?

No. It's a tracking code. The serious mental illness premium is paid during the fiscal year as a special payment once enough enrolled patients are tracked (OMA Q-codes guide p.9; Agreement p.68 §8.11).

Sources

All OHIP billing codes by service · See how APEX works · Pricing