A990 – First person seen
OHIP General Listings Code — GENERAL PREAMBLE · Schedule of Benefits
A special visit premium payable for the first patient seen during a non-elective special visit to a physician's office on weekdays between 07:00 and 17:00, provided the physician traveled to the office specifically for the visit.
When to Use
- Bill A990 when a physician travels to their office specifically to see the first patient during weekday daytime hours (07:00-17:00) for a non-elective visit.
- Use A990 in conjunction with an A-prefix assessment code (e.g., A001) and A960 when the physician makes a special trip to the office for the first patient during weekday daytime hours.
- A990 is appropriate for the first patient seen during a non-elective special visit to the office, provided the physician traveled there for that specific purpose during weekday daytime.
Common Pitfalls
- Billing A990 when the physician was already at the office for other reasons, as the code requires travel to the office specifically for the visit.
- Submitting A990 for patients seen during routine office hours or when the office is already open for scheduled appointments, as it's intended for non-elective special visits.
- Attempting to bill A990 for virtual care visits, as special visit premiums are not applicable to telephone or video consultations.
Billing Tips
- Always document the exact time of the special visit and confirm the non-elective nature of the service on the patient's medical record to support A990 claims.
- Ensure A990 is billed with an eligible assessment or diagnostic/therapeutic procedure code and A960 when applicable for weekday daytime special visits.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Special Visit Premium
Premium
The time of the special visit must be documented on the medical record.
The service must be non-elective.
Special visit premiums are intended to compensate for the disruption and travel associated with non-elective emergency visits.
Table VIII (Physician Office) does not provide for 'additional person seen' premiums; only the first person seen is eligible.
Virtual care (video or telephone) is not eligible for special visit premiums.
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