How do I bill service code K083?
K083 would be billed in place of the applicable in-person visit fee for telephone and video visits. According to the OHIP Bulletin #4745, the quantity for K083 = listed fee of the services provided in the SoB, rounded to the nearest $5, divided by 5.
The below table provides an example (for Internal Medicine specialty):
Code |
Description |
Fee |
K083 Units |
K083 Fee |
A135 |
Consultation |
$157.00 |
31 |
$155.00 |
A435 |
Limited consultation |
$105.25 |
21 |
$105.00 |
A136 |
Repeat consultation |
$105.25 |
21 |
$105.00 |
A133 |
Medical specific assessment |
$79.85 |
16 |
$80.00 |
A134 |
Medical specific re-assessment |
$61.25 |
12 |
$60.00 |
A131 |
Complex medical specific re-assessment |
$70.90 |
14 |
$70.00 |
A138 |
Partial assessment |
$38.05 |
8 |
$40.00 |
How to submit K083A with a quantity over 99 units?
The Ministry of Health's system only accepts 2 digits for quantity. As such, a service with over 99 units needs to be broken into two entries.
For example, if you want to submit a K083 and the total number of units is 128, you need to submit K083A twice - One with 99 units and the other one with 29 units. (see below).
REMINDER: You will need to flag the claim for manual review by checking the "Manual Review" box and submitting your notes to the Ministry of Health (either by fax or via eSubmit).
Convert to K083A
We have developed a new feature "Convert to K083A" that allows you to easily convert regular in-person codes to K083. With a simple click, convert an in-person consultation or visit code to K083 with the correct quantity.
Depending on your discipline of medicine and practice, you may find the automatic virtual codes A[][]VA or E[][]VA a better solution.
Here are the steps:
On the Web portal - NEW CLAIM page
Step 1: Enter the in-person service code and click Add Entry (F7)
Step 2: Click Action on the right-hand side of the service code -> select Convert to K083A
The service code will then be replaced with K083A with the appropriate quantity.
On the MY PATIENT LIST page:
Step 1: Select the in-person service code
Step 2: Click the Edit (pen) button for the service code
Step 3: Check off Convert to K083A and click OK button
The service code box will change to orange, which indicate the code will be converted to K083A.
On the MDBilling.ca Mobile App - Claim screen
Step 1: Enter the in-person visit/assessment code(s)
Step 2: Tap on Service Entered to view the service code(s) entered
Step 3: Swipe right on the code that you wish to be converted to K083 and tap Convert to K083A
The service code will then be replaced with K083A with the appropriate quantity.
Note: This feature is only available for the A-suffix in-person outpatient Consultation and Visits codes.
Don't forget to enable the Auto-Populate Virtual Tracking Code feature. This feature will help you automatically add the K300/K301 to your virtual services as per the new rules from OHIP INFOBulletin 210904.
If you have more questions about billing for virtual care, our COVID-19 virtual care billing section has more information.