OHIP billing code for ODSP forms

Updated October 26, 2026

ODSP forms aren't OHIP-insured services, but you still claim them through OHIP: the Ministry of Health pays the Appendix F codes on behalf of the Ministry of Children, Community and Social Services. For an initial ODSP application, bill K050A ($116.15) for the Health Status Report and Activities of Daily Living Index together, or K051A ($92.90) or K052A ($23.20) when only one is completed.

Code	What it is	Fee	When to bill it
K050A	Health Status Report and ADL Index together, initial ODSP application	$116.15	You complete both parts of the Disability Determination Package.
K051A	Health Status Report only, initial ODSP application	$92.90	You complete the Health Status Report and someone else does the ADL Index.
K052A	Activities of Daily Living Index only, initial ODSP application	$23.20	You complete only the ADL Index.
K057A	Medical Form Part A, ODSP Medical Review	$40.70	Part A of a Medical Review.
K058A	Medical Form Part B (Health Status Report and ADL Index), Medical Review	$145.15	Both parts of Part B of a Medical Review.
K059A	Health Status Report of Part B only, Medical Review	$116.15	Only the Health Status Report of Part B.
K060A	ADL Index of Part B only, Medical Review	$29.05	Only the ADL Index of Part B.
K054A	Mandatory Special Necessities Benefit Request Form	$29.05	That ODSP form.
K055A	Application for Special Diet Allowance	$23.20	That form.
K056A	Application for Pregnancy/Breast-feeding Nutritional Allowance	$23.20	That form.

How to bill it

Match the code to the exact form. Each Appendix F code is specific to its form and can't be claimed for any other government document (AF2).

For a new ODSP application, bill K050A when you complete both the Health Status Report and the ADL Index, or K051A/K052A for one part. For a Medical Review, bill K057A for Part A and K058A, K059A or K060A for Part B (AF1).

Submit the claim to OHIP like any other claim, under the patient's health number.

If you also assess the patient for a medical problem at the visit, bill the assessment as well.

Billing rules

Appendix F services are not insured services under the Health Insurance Act; the Ministry of Health pays them as paying agent for the Ministry of Children, Community and Social Services (AF1).
The MCCSS forms are given to patients only by social services staff; the fee codes are specific to each form and aren't to be claimed for completing any other government document (AF2).
K050 covers both parts together; don't bill K051 or K052 for the same application as well (AF1).
The Ontario Works Limitation to Participation form is a different code, K053A ($17.45) (AF2).
Both the Health Status Report and ADL Index are mandatory parts of the Disability Determination Package; one professional can complete both, or two can split them (ODSP guide for health care professionals).
FHO Income Stabilization physicians may bill K050A–K056A at full fee-for-service value (Agreement p.99, Appendix J §3.4–3.6).

Questions

What is the OHIP billing code for ODSP forms?

Can I charge the patient for the ODSP form?

For the forms listed in Appendix F, the Ministry of Health pays you on behalf of MCCSS through OHIP (AF1), so bill the K-code. Appendix F doesn't list every ODSP or social services document; each code is only for its own form (AF2).

How long does the patient have to return the Disability Determination Package?

The Ministry says the patient and health care professional have 90 calendar days to submit the completed package, and the patient can ask the Disability Adjudication Unit for an extension (ODSP guide for health care professionals).

Sources

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