B988 – First person seen - Geriatric Home Visit
OHIP Paediatrics Code — GENERAL PREAMBLE · Schedule of Benefits
This special visit premium is for the first person seen during a Geriatric Home Visit as outlined in SPECIAL VISIT PREMIUM TABLE X on page . It is payable for services rendered during: - Weekdays Daytime (07:00-17:00) - Evenings (17:00-24:00) Monday through Friday - Daytime Saturdays, Sundays, and Holidays (07:00-24:00) - Nights (00:00-07:00) Monday through Friday As per page , this premium is only eligible for payment to: a. a specialist in Geriatrics (07); or b. a physician with an exemption to access bonus impact in Care of the Elderly from the MOH. As per page , claims must be submitted with an appropriate A-prefix assessment fee and the time of the visit must be documented in the medical record. As per page , special visits to a patient's home may be for elective or non-elective services. Based on the rules for home visit premiums (see page ), this is payable only for the first patient seen per visit. The 'no max. per time period' note indicates that a physician may claim this premium for multiple separate visits within the eligible timeframes. Note that B987 is used for Sacrifice of Office Hours.
When to Use
- Use B988 when performing a home assessment for a geriatric patient during evenings, weekends, or holidays, provided you hold the required Care of the Elderly exemption or Geriatrics specialty designation.
- Use B988 for the first patient seen during a home visit when the visit is specifically initiated for a geriatric assessment, ensuring it is paired with an A-prefix assessment code like A007 or A008.
Common Pitfalls
- Billing B988 for patients residing in long-term care facilities or nursing homes, which is explicitly prohibited under the General Preamble rules for home visit premiums.
- Claiming B988 for patients seen during routine office hours or when the physician is already at the location for other scheduled appointments, as this violates the 'special visit' requirement.
- Failure to document the exact time of the visit in the medical record, which is a mandatory audit requirement for all special visit premiums.
Billing Tips
- Ensure the claim includes both the B988 premium and the appropriate A-prefix assessment code; the premium will be rejected if the base assessment code is missing or incorrect.
- If seeing multiple patients at the same residence, only the first patient qualifies for B988; subsequent patients seen during the same trip are billed using the appropriate assessment code only.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table X - Geriatric Home Visit), Other Premiums (including After Hours Procedure Premiums)
The time at which the special visit takes place must be documented on the medical record.
For the purpose of special visit premiums under the heading 'Geriatric Home Visit Special Visit Premiums', the special visit premiums listed in Table X are only eligible for payment to: a. a specialist in Geriatrics (07); or b. a physician with an exemption to access bonus impact in Care of the Elderly from the MOH.
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