B961 – Travel Premium - Weekdays Evenings
OHIP Paediatrics Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium for a non-elective special visit to a patient's home (other than a Long-Term Care Institution). This premium is applicable for visits made during weekdays between 17:00 and 24:00. A special visit is defined as a visit initiated by a patient or their representative for a non-elective service. This premium is paid in addition to the fee for the primary assessment service rendered during the visit.
When to Use
- Use B961 when you are called out to a patient's private residence for an urgent, non-elective assessment between 17:00 and 24:00 on a weekday.
- Use this code when you must travel specifically to a patient's home for an acute clinical issue that cannot wait until the next business day, provided the visit is not part of your routine office hours.
Common Pitfalls
- Billing B961 for visits occurring during your scheduled office hours, even if those hours extend into the evening, will result in rejection.
- Attempting to claim B961 alongside A001 or A007 is prohibited, as travel is considered a built-in component of those specific home visit assessment codes.
- Claiming B961 for patients in a Long-Term Care facility or nursing home is an automatic audit trigger, as this premium is strictly for private residences.
Billing Tips
- Ensure the exact start time of the visit is clearly documented in the patient's chart to substantiate the 17:00-24:00 window requirement.
- If seeing multiple patients at the same residence, claim the B961 only once for the trip, but bill the appropriate assessment fee for each individual patient seen.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table VI - Special Visits to Patient's Home)
Only one travel premium is eligible for payment for each separate trip to a destination regardless of the number of patients seen in association with each trip.
Maximum 2 services per time period.
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