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A964
A964 – Travel Premium
OHIP General Listings Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium payable for a special visit to a physician's office initiated by a patient for non-elective services, specifically for travel occurring during the night time period (00:00-07:00).
When to Use
- Bill A964 when a patient calls you to their office between 00:00 and 07:00 for an urgent, non-elective issue, and you travel to the office specifically for that patient.
- Use A964 if you are called to the office for an urgent patient matter during the night, and the patient's condition necessitates an immediate assessment outside of regular hours.
- A964 is appropriate when a patient requires a special visit to your office during the night (00:00-07:00) for a non-elective service, and you are not already present at the office for other reasons.
Common Pitfalls
- Do not bill A964 if the patient presents to your office without an appointment during the night, as this is considered a walk-in and not a special visit initiated by the patient for travel compensation.
- Avoid billing A964 if you are already at the office for routine hours or another scheduled patient; the premium is for travel initiated by the patient's urgent need during specific night hours.
- A964 is not payable if the visit occurs while you are performing hospital rounds or in a long-term care facility, even if it's during the night; these scenarios have different billing rules.
Billing Tips
- Document the exact time of the patient's visit in the medical record to support the A964 claim, ensuring it falls within the 00:00-07:00 window.
- A964 can be billed alongside a regular assessment fee (e.g., K001) for the patient's visit, but only one travel premium (A964, A960, A962, A963) is allowed per trip, regardless of the number of patients seen.
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 visit must be documented in the medical record
Only one travel premium is eligible per trip regardless of the number of patients seen.
Not eligible for travel within the same building or hospital complex.
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