Pre-Dental General Assessment

This service shall consist of examination and documentation as is required for patients undergoing a general anaesthetic for surgical dental procedures only

General Practitioners may also bill this code for examination and documentation as is required for: 

i) children and adolescents undergoing diagnostic imaging studies under conscious sedation and: 

ii) patients undergoing a general anaesthetic for ECT.  

Psychiatric Care 

This service is any form of assessment and treatment by a Psychiatrist for mental illness, behavioural maladaption and/or other problems that are assumed to be of an emotional nature, in which there is consideration of, and alteration of the patient’s biological and psychosocial functioning.

Charges for hospital visits, home or office fees do not apply on a day when ECT or Psychiatric Care is charged, (same diagnosis, same physician).

Psychiatric Care is not payable on the same day as ECT.

Rules for the Claiming of Psychiatric Care  

 The minimum time period for Psychiatric Care (to be claimed as such) is 15 minutes. Claims for one or more units of Psychiatric Care should be made reflecting the following requirements of actual documented time spent with the patient.

Individual 

1 unit – 15 to 44 minutes 

2 units – 45 to 74 minutes 

3 units – 75 to 104 minutes

4 units – 105 to 134 minutes

5 units – 135 to 164 minutes, and so on

Psychiatric Day Care

This service may be claimed by Psychiatrists for visits to patients who are seen in a Psychiatry Day Care setting. It is not a per diem rate and may only be billed for a patient with whom an actual exchange took place during that visit.

Psychotherapy

For purposes of being an MCP-insured service, psychotherapy is defined as the treatment of mental illness, behavioural maladaptions, and/or other problems that are of an emotional nature, in which a physician deliberately establishes a professional relationship with a patient for the purpose of removing, modifying, or retarding existing symptoms, or attenuating or reversing disturbed patterns of behaviour, and/or promoting positive personality growth and development.

Psychotherapy may only be claimed when the physician purposefully undertakes to treat the patient’s emotional problem and that undertaking must be reflected in both the patient’s record and the diagnostic code used on the claim. The patient’s record must also include a note of the actual time spent as “psychotherapy” during that visit.

Counselling of a patient with a complex non-psychiatric illness is included in the visit fee and should not be claimed as psychotherapy. Marital and family counseling may be claimed as psychotherapy. 

Charges for hospital visits, home or office fees do not apply on a day when ECT or individual psychotherapy is charged, (same diagnosis, same physician).

Psychotherapy is not payable on the same day as ECT.

The minimum time period for psychotherapy (to be claimed as such) is 15 minutes. Claims for one or more units of psychotherapy should be made reflecting the following requirements of actual documented time spent with the patient.

Individual 

1 unit – 15 to 44 minutes

 2 units – 45 to 74 minutes 

3 units – 75 to 104 minutes

 4 units – 105 to 134 minutes 

5 units – 135 to 164 minutes, and so on 

Group 

1 unit – 30 to 89 minutes 

2 units – 90 to 149 minutes

3 units – 150 to 209 minutes 

4 units – 210 to 269 minutes

5 units – 270 to 329 minutes, and so on