Physician Payment and Policy Ontario Health Insurance Program
Resource Manual for Physicians
 
2.2   General Preamble (Continued)

Psychotherapy and Counselling Services

Psychotherapy (K007) is treatment for mental illness, behavioural maladaptations, or emotional problems, in which a physician deliberately establishes a professional relationship with a patient for the purpose of removing or modifying existing symptoms attributed to the problem.

Individual counselling (K013, K033) is defined as a patient visit dedicated solely to an educational dialogue between the patient and a physician. Advice provided to a patient that would ordinarily constitute part of a consultation, assessment or other treatment, is included as a common or constituent element of such other service, and does not constitute counseling in this context. If the patient does not have a pre-booked appointment, the amount payable for this service will be adjusted to a lesser assessment fee.

Delegated Procedure

A Delegated Procedure is a procedure carried out by a physician’s employee where the service remains insured if certain conditions are met. Procedures in this context do not include such services as assessments, consultations, psychotherapy, counseling, etc. Unless certain exceptions are met, one of the requirements is for “direct supervision”, that is, the physician must be physically present in the office or clinic at which the service is rendered (for complete information refer to the General Preamble).

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