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A960

A960Travel Premium

OHIP General Listings Code — GENERAL PREAMBLE · Schedule of Benefits

A travel premium eligible for payment when a physician is required to travel to their office for a non-elective special visit initiated by the patient or patient's representative, during weekday daytime hours when the office is not otherwise scheduled to be open.

When to Use

  • Bill A960 when a patient calls urgently during the day for a non-elective visit to your office, requiring you to return to the office when it's otherwise closed.
  • Use A960 if you are called back to your office for a patient requiring a special visit outside of your regularly scheduled office hours on a weekday.
  • A960 is appropriate when a patient's representative contacts you for an unscheduled, urgent visit to your office during weekday daytime hours.

Common Pitfalls

  • Claims for A960 are rejected if the patient presented to the office without an appointment while the physician was already present for scheduled hours.
  • Do not bill A960 if the patient's visit immediately precedes or follows your regular office hours, as this indicates the office was already open or scheduled to open.
  • A960 is not payable with H-prefix codes, as it is intended for physician office visits, not emergency department services.

Billing Tips

  • Always submit A960 with an eligible A-prefix assessment code (e.g., A001, A007) and the A990 first-person-seen premium.
  • Ensure the medical record clearly documents the specific time the special visit occurred, as required for A960.
Provider Fee$37.40

Effective: April 1, 2026

Category

GP. General Preamble

Subcategory

GENERAL PREAMBLE

Service Type

Special Visit Premium

Code Classes

Premium

The time of the special visit must be documented in the medical record

Special visit premiums are not eligible for virtual care services

Not eligible with H-prefix emergency department codes

Not eligible for hospital rounds or elective admissions

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