[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"guide-en-ontario-mental-health-billing":3},{"doc":4,"fallback":297},{"id":5,"title":6,"author":7,"authorSlug":7,"badge":7,"body":8,"category":279,"color":7,"description":280,"extension":281,"icon":7,"lastReviewed":282,"meta":283,"navigation":284,"path":285,"publishedAt":286,"reviewedBy":287,"seo":288,"slug":289,"stem":290,"subtitle":7,"tags":7,"takeaways":291,"updatedAt":286,"__hash__":296},"guides\u002Fguides\u002Fontario-mental-health-billing.md","Ontario Mental Health Billing Guide 2026",null,{"type":9,"value":10,"toc":262},"minimark",[11,15,20,27,130,134,137,171,177,181,184,189,206,210,230,234,238,241,245,248,252,255,259],[12,13,14],"p",{},"OHIP K-codes for psychiatrists, private insurance billing for psychologists and registered psychotherapists, publicly funded programs, and documentation requirements, in one complete reference.",[16,17,19],"h2",{"id":18},"who-can-bill-what-in-ontario","Who Can Bill What in Ontario",[12,21,22,26],{},[23,24,25],"strong",{},"Key distinction:"," OHIP covers psychiatrists and physicians only. Psychologists, registered psychotherapists (RPs), and registered social workers (RSWs) in private practice bill insurance or self-pay, not OHIP.",[28,29,30,50],"table",{},[31,32,33],"thead",{},[34,35,36,41,44,47],"tr",{},[37,38,40],"th",{"align":39},"left","Professional",[37,42,43],{"align":39},"College",[37,45,46],{"align":39},"OHIP",[37,48,49],{"align":39},"Private Insurance",[51,52,53,70,84,100,115],"tbody",{},[34,54,55,61,64,67],{},[56,57,58],"td",{"align":39},[23,59,60],{},"Psychiatrist (MD)",[56,62,63],{"align":39},"CPSO",[56,65,66],{"align":39},"Yes (K-codes)",[56,68,69],{"align":39},"Rarely",[34,71,72,77,79,82],{},[56,73,74],{"align":39},[23,75,76],{},"Physician \u002F GP",[56,78,63],{"align":39},[56,80,81],{"align":39},"Yes (A\u002FGP codes)",[56,83,69],{"align":39},[34,85,86,91,94,97],{},[56,87,88],{"align":39},[23,89,90],{},"Psychologist",[56,92,93],{"align":39},"CPO",[56,95,96],{"align":39},"No",[56,98,99],{"align":39},"Yes",[34,101,102,107,110,112],{},[56,103,104],{"align":39},[23,105,106],{},"Registered Psychotherapist (RP)",[56,108,109],{"align":39},"CRPO",[56,111,96],{"align":39},[56,113,114],{"align":39},"Yes (most plans)",[34,116,117,122,125,127],{},[56,118,119],{"align":39},[23,120,121],{},"Registered Social Worker (RSW)",[56,123,124],{"align":39},"OCSWSSW",[56,126,96],{"align":39},[56,128,129],{"align":39},"Yes (many plans)",[16,131,133],{"id":132},"ohip-k-codes-for-ontario-psychiatrists","OHIP K-Codes for Ontario Psychiatrists",[12,135,136],{},"Psychiatrists bill OHIP using K-codes from the Schedule of Benefits. Common codes include:",[138,139,140,147,153,159,165],"ul",{},[141,142,143,146],"li",{},[23,144,145],{},"K007",": Psychiatric assessment, less than 50 minutes.",[141,148,149,152],{},[23,150,151],{},"K008",": Psychiatric assessment, 50 minutes or more.",[141,154,155,158],{},[23,156,157],{},"K029",": Psychiatric consultation (requires referral).",[141,160,161,164],{},[23,162,163],{},"K040",": Individual psychotherapy (20–45 min).",[141,166,167,170],{},[23,168,169],{},"K041",": Individual psychotherapy (45+ min).",[12,172,173,176],{},[23,174,175],{},"Documentation tip:"," OHIP audits may request clinical notes to substantiate billing. Recording validated outcome measures (PHQ-9, GAD-7) strengthens medical necessity documentation.",[16,178,180],{"id":179},"private-insurance-billing","Private Insurance Billing",[12,182,183],{},"Major insurers (Canada Life, Sun Life, Manulife, Green Shield) cover psychotherapy and psychological services under extended health benefit plans. Annual limits typically range from $500 to $2,500.",[185,186,188],"h3",{"id":187},"what-to-include-on-a-receipt","What to Include on a Receipt:",[138,190,191,194,197,200,203],{},[141,192,193],{},"Practitioner name and College registration number.",[141,195,196],{},"Patient name and date of birth.",[141,198,199],{},"Service date and duration.",[141,201,202],{},"Service description (e.g., \"Individual psychotherapy\").",[141,204,205],{},"Fee charged and amount paid.",[16,207,209],{"id":208},"publicly-funded-programs","Publicly Funded Programs",[138,211,212,218,224],{},[141,213,214,217],{},[23,215,216],{},"Ontario Structured Psychotherapy (OSP)",": Free government-funded CBT for adults with anxiety or depression. Accessed by self-referral or GP referral.",[141,219,220,223],{},[23,221,222],{},"CMHA Ontario",": Free community mental health services including counselling and crisis support.",[141,225,226,229],{},[23,227,228],{},"Connex Ontario",": 24\u002F7 referral system for mental health and addictions (1-866-531-2600).",[16,231,233],{"id":232},"frequently-asked-questions","Frequently Asked Questions",[185,235,237],{"id":236},"does-ohip-cover-therapy-in-ontario","Does OHIP cover therapy in Ontario?",[12,239,240],{},"OHIP covers mental health services provided by psychiatrists and GPs. It does NOT cover psychologists or RPs in private practice.",[185,242,244],{"id":243},"can-ontario-psychologists-bill-ohip","Can Ontario psychologists bill OHIP?",[12,246,247],{},"No. Psychological services are covered only when provided as part of a hospital or community mental health centre funded by the Ministry of Health.",[185,249,251],{"id":250},"can-registered-psychotherapists-rps-bill-insurance","Can registered psychotherapists (RPs) bill insurance?",[12,253,254],{},"Yes. Many extended health benefit plans cover CRPO-registered psychotherapists. Coverage varies by plan.",[185,256,258],{"id":257},"what-documentation-is-needed-for-insurance-billing","What documentation is needed for insurance billing?",[12,260,261],{},"Practitioners need to provide detailed receipts including registration numbers, session dates, and service types. Validated outcome measures (PHQ-9, GAD-7) are increasingly used for utilization reviews.",{"title":263,"searchDepth":264,"depth":264,"links":265},"",2,[266,267,268,272,273],{"id":18,"depth":264,"text":19},{"id":132,"depth":264,"text":133},{"id":179,"depth":264,"text":180,"children":269},[270],{"id":187,"depth":271,"text":188},3,{"id":208,"depth":264,"text":209},{"id":232,"depth":264,"text":233,"children":274},[275,276,277,278],{"id":236,"depth":271,"text":237},{"id":243,"depth":271,"text":244},{"id":250,"depth":271,"text":251},{"id":257,"depth":271,"text":258},"Billing","Ontario mental health billing guide. Covers OHIP K-codes for psychiatrists, private insurance for psychologists and RPs, and OSP free therapy.","md","April 2026",{},true,"\u002Fguides\u002Fontario-mental-health-billing","2026-02-21","HiBoop",{"title":6,"description":280},"ontario-mental-health-billing","guides\u002Fontario-mental-health-billing",[292,293,294,295],"OHIP covers psychiatrists and general practitioners (K-codes) for mental health services.","Psychologists, RPs, and RSWs in private practice bill through insurance or self-pay.","The Ontario Structured Psychotherapy (OSP) program provides free government-funded CBT.","Insurance receipts must include practitioner registration numbers and session details.","NE2n4imbWzHxHIjykOG_4UKrVOQlnC0tM0RLqERmCP0",false]