OHIP billing code for Form 1
Updated October 26, 2026
The OHIP billing code for a Form 1 is K623A, application for psychiatric assessment under the Mental Health Act, $133.60. It includes the history, examination, notifying the patient, family and authorities, and completing the form; a consultation or assessment billed the same day pays nil.
| Code | What it is | Fee | When to bill it |
|---|---|---|---|
| K623A | Application for psychiatric assessment (Form 1) | $133.60 | You examine the patient and complete a Form 1 application for psychiatric assessment. |
How to bill it
Bill K623A for the Form 1. The fee covers the psychiatric history, inquiry and examination you need to complete it, notifying the patient, family, patient representative and relevant authorities, and completing the form (A24, GP34).
Don't also bill an assessment for the same day: consultations or assessments claimed in addition to certification the same day pay nil (A25).
Keep the completed Form 1 in the chart. The Schedule accepts it as the documented request for a consultation for involuntary psychiatric treatment (A25).
Use the diagnostic code for the condition you suspect.
Billing rules
- K623 includes the necessary history, examination, notification of the patient, family and relevant authorities, and completion of the form (A24, GP34).
- Consultations or assessments claimed in addition to certification or re-certification the same day are payable at nil (A25).
- Certification of financial incompetence, including the assessment to decide it, is not an insured service (A25).
- Examinations and documents under the Mental Health Act are insured; the exclusion for completing third-party documents doesn't apply to them (Reg. 552 s.24(1.1) para 5).
- Under the Mental Health Act, a Form 1 is only effective if the physician signs it within seven days after examining the person, and it is authority for seven days from the day it is signed (MHA s.15(4)–(5)).
- May be done by video or phone as comprehensive virtual care with K300A or K301A; by phone it pays 85% (AJ1, A70).
- FHO: out of basket, so it is paid fee-for-service (Agreement Schedule 2, p.79).
Questions
What is the OHIP billing code for Form 1?
The OHIP billing code for a Form 1 is K623A, application for psychiatric assessment under the Mental Health Act, $133.60. It includes the history, examination, notifying the patient, family and authorities, and completing the form; a consultation or assessment billed the same day pays nil.
Can I bill an A007A or A003A with the Form 1?
You can submit it, but a consultation or assessment claimed the same day as a certification pays nil (A25). K623A already includes the history and examination.
Can the patient be charged for a Form 1?
No. Examinations and forms under the Mental Health Act are insured services (Reg. 552 s.24(1.1) para 5), and K623A is the OHIP fee.
Related: OHIP billing code for Form 3 · OHIP billing code for bipolar disorder · OHIP billing code for ADHD · OHIP billing code for phone visit
Sources
- Schedule of Benefits: Physician Services (effective July 1, 2026)
- Mental Health Act, R.S.O. 1990, c. M.7
- Health Insurance Act, R.R.O. 1990, Reg. 552, section 24 (uninsured services)
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