Palliative Care Billing for FHO Physicians in Ontario

Quick reference for common OHIP palliative-care billing services used by Ontario family physicians.

For OHIP billing purposes, the Schedule defines palliative care as care to a terminally ill patient in the final year of life where aggressive treatment of the underlying disease has stopped and care is directed toward comfort until death.

The current Schedule of Benefits: Physician Services remains the authoritative source for eligibility and billing requirements.

Which code fits the work you did?

Code	Use it for	Key rule
A945	Special palliative-care consultation	Minimum 50 minutes; document start and stop times.
K023	Palliative-care support	Standalone time-based service for pain and symptom management, emotional support and counselling.
G511	Telephone management	Telephone advice regarding a patient receiving palliative care at home; maximum two per week.
G512	Weekly palliative-care case management	Weekly supervision and coordination by the physician most responsible or a substituting physician; maximum one per week.
B966	Palliative home-visit travel premium	Check the Schedule conditions for an eligible palliative home visit.
B998 / B997	Palliative home-visit first-person-seen premiums	B998 applies from 07:00–24:00 under the table conditions; B997 applies 00:00–07:00.

A945 — Special palliative-care consultation

• Think: comprehensive palliative consultation.
• Minimum 50 minutes.
• Majority of consultation time must involve the patient.
• Includes the additional palliative-consultation elements required by the Schedule.
• Record start and stop times.

First 50 qualifying minutes → A945
Additional qualifying palliative-support time → K023

The same minutes cannot be counted toward both services.

K023 — Palliative-care support

K023 can be billed as a standalone service. A945 is NOT a prerequisite.

• Time-based palliative support.
• Pain and symptom management.
• Emotional support.
• Counselling.
• Claimed in half-hour units or major part thereof.
• Record start and stop times.
• Other Family Practice consultation/visit services are generally not payable when rendered with K023, except A945/C945 where the respective requirements are met.

K023 alone:
Qualifying palliative-support encounter → K023

A945 + K023:
First 50 qualifying consultation minutes → A945
Additional qualifying support time → K023

G511 — Telephone management at home

• Individual telephone-management service.
• Patient must be receiving palliative care at home.
• Physician personally provides the service.
• Maximum two per week.
• Record a dated summary of the call.
• Not payable when the same physician renders a consultation, assessment, time-based service or other visit to the patient on the same day.
• Physician must be the physician most responsible for the patient or a substituting physician.

G512 — Weekly palliative-care case management

Think: supervision and coordination of the patient’s palliative care over the week.

• Monitoring the patient’s condition.
• Ordering and interpreting tests.
• Telephone advice to the patient/family/representative.
• Arranging assessments, procedures or therapy.
• Coordinating community and hospital care.
• Physician must be the MRP or substitute.
• Maximum one per week per patient.
• G511, K071 and K072 are not separately payable during a week when G512 is rendered.
• Other eligible services such as K023, assessments and special-visit premiums may remain payable when their own requirements are met.

Palliative home visits

Code	Purpose	Timing
B966	Travel premium	Eligible palliative home visit
B998	First person seen	07:00–24:00
B997	First person seen	00:00–07:00

The current Schedule’s palliative-home-visit table lists these premiums with no maximum per time period.

Documentation — 30-second checklist

• Palliative-care billing context supported in the chart.
• Service actually provided is clear.
• Start/stop times when required.
• Dated telephone summary for G511.
• MRP/substitute role where required.
• Home-visit timing/location where applicable.
• Virtual modality where applicable.

Two important cautions

MAID is separate

Effective April 1, 2026, Ontario introduced dedicated MAID billing codes. Do not use A/C945 or K023 for MAID-specific services where the dedicated MAID listings apply.

FHO payment is not the same as fee-code eligibility

Valid OHIP service
→ documentation supports it
→ submit the appropriate service
→ applicable FHO remuneration rules determine payment

The underlying Schedule requirements must still be met.

Bottom line

A945 → comprehensive ≥50-minute palliative consultation
K023 → standalone time-based palliative support
G511 → individual telephone management for a palliative patient at home
G512 → ongoing weekly palliative case management
B966 / B998 / B997 → eligible palliative home-visit premiums

Document what you did. Document the time. Choose the code that describes the actual service.

Sources

• Ontario Ministry of Health — Schedule of Benefits: Physician Services, current 2026 Schedule.
• Ontario Ministry of Health / OMA — Education and Prevention Committee billing guidance on time-based and virtual-care services.
• Ontario Ministry of Health — 2026 physician fee-schedule amendments.