OHIP billing code for counselling

OHIP counselling codes: K013A for individual counselling and K040A for pre-booked group counselling, each per half-hour unit.

Code	What it is	Fee
K013A	Counselling - up to 3 units/yr	$80.00
K040A	Group counselling, per unit, where no group member received > 3 units K013 or K040 per 12 month period	$80.00

K013A: Counselling - up to 3 units/yr

Individual counselling by the physician, billed per half-hour unit. The first 3 units per patient per physician in 12 months bill as K013.

Billing rules

K013 covers the first 3 units of K013 and K040 (group) combined per patient per physician per 12 months; later units are K033 (A21, GP58).
The visit must be pre-booked, or OHIP pays it as a lesser assessment (GP58).
The same day, you can only be paid for services on the GP58 list (for example E080, G365, G372, immunizations, K002, K003, K008, K015, K730). An assessment that day is not payable (GP58).
Units are ½ hour or major part: 1 unit = at least 20 minutes, 2 units = 46, 3 units = 76, 4 units = 106, then every 30 minutes more (GP55).
Count consecutive time in direct contact with the physician in person, excluding other separately billed services and chart work (GP54, GP55).

Common rejections

AT3: Usually means it was billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person visit with you in the past 24 months (AT3 guide; A66).
VJ7: The claim reached OHIP more than three months after the service date; resubmit as stale-dated only if it was first sent on time (VJ7 guide; GP9).
VH8: The date of birth doesn't match OHIP's record for the health number; correct it and resubmit (VH8 guide).
EH2: The health card version code doesn't match OHIP's record; get the current version code and resubmit (EH2 guide).
CNA: 'Counselling not allowed': check for another service you billed that day that isn't on the GP58 same-day list (GP58).

The full K013A guide

K040A: Group counselling, per unit, where no group member received > 3 units K013 or K040 per 12 month period

Pre-booked group counselling for 2 or more patients, per half-hour unit, while no member has had more than 3 units of K013/K040 from you in 12 months.

Billing rules

Individual and group counselling are limited to 3 units per patient per physician per year at the higher fee (K013 or K040); later units are paid at the lesser fee (K033 or K041) (A21, GP58).
Must be pre-booked, with an ongoing physician-patient relationship (GP58, GP59).
Keep a separate record, apart from the medical records, of the names and health numbers of everyone at each session, or it is not payable (GP59).
Submit the claim under the health number of the group member who, at that time, had the most counselling units already claimed by you that year (GP59).
The same day, only the services on the counselling list are payable with it by you (for example G372, K002, K003, K008, K035, K038, K730); an assessment or K030 that day is not (GP58).

Common rejections

EH2: The health card version code doesn't match OHIP's record, often because the patient has a newer card; get the current version code and resubmit (EH2 guide).
R02: OHIP found the health number invalid. Group counselling is claimed under one member's health number (GP59), so check that number and version code against that member's card.
CNA: 'Counselling not allowed': usually another service you billed that day, such as an assessment or K030, isn't on the counselling same-day list (GP58). Remove one service or correct the date.
VH9: The health number on the claim isn't registered with the Ministry; check the group member's number used on the claim against their card and resubmit (VH9 guide).

The full K040A guide

More counselling and mental health codes

Questions

What is the OHIP billing code for counselling?

OHIP counselling codes: K013A for individual counselling and K040A for pre-booked group counselling, each per half-hour unit.

All OHIP billing codes by service

Updated October 26, 2026.