K133Periodic health visit for adults with Intellectual and Developmental Disabilities (IDD)
CONSULTATIONS AND VISITS · GENERAL LISTINGS · FAMILY PRACTICE & PRACTICE IN GENERAL (00)
$164.25What this reference tells you
K133 identifies the Ontario insured service described as “Periodic health visit for adults with Intellectual and Developmental Disabilities (IDD).” The listed fee and rules are reference data; the clinical record must support the service actually performed.
Loaded billing requirements
- 1.K133 is limited to one per patient per 12 month period.
- 2.Only one of K133, K131, or K132 is eligible for payment per patient per physician per 12 month period.
- 5.K133 is only payable when the patient has one of the following conditions (listed with ministry diagnostic codes): a.Autism spectrum disorder (299) b.Intellectual disability or Fetal Alcohol Syndrome (319) c.Cerebral palsy (343) d.Spina bifida, with or with...
Billing detail
Frequency limit recorded in the structured source: 1 service(s) per 12 month(s).
Before using this code
Confirm the current Ministry publication, the patient and provider context, the date of service, and documentation supporting the claim. A searchable reference does not establish eligibility or guarantee payment.