B990 – First person seen
OHIP Paediatrics Code — GENERAL PREAMBLE · Schedule of Benefits
A special visit premium payable for the first patient seen during a visit to a patient's home (other than a Long-Term Care Institution) for either a non-elective service during weekday daytime hours or an elective service at any time.
When to Use
- Bill B990 for the first patient seen in their private residence during weekday daytime hours for a non-elective service, provided you travelled from another location.
- Use B990 for the first patient seen in their private residence at any time (including evenings, nights, weekends) for an elective service, provided you travelled from another location.
- B990 is applicable when providing a consultation (e.g., A003) or a diagnostic/therapeutic procedure in a patient's home as the first patient of a trip.
Common Pitfalls
- Billing B990 for patients in a long-term care facility or hospital, as these locations are excluded.
- Claiming B990 for subsequent patients seen during the same home visit trip; only the first patient is eligible.
- Submitting B990 in conjunction with A001 or A007 for a home visit, as these codes include travel and do not permit premium add-ons.
Billing Tips
- When seeing multiple patients in the same apartment building, only the first patient seen in their individual unit qualifies for B990, even if each unit has a separate entrance.
- B990 can be billed alongside B960 (Travel premium) for the same trip, but only one B960 is allowed per trip, regardless of the number of patients seen.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Special Visit Premium
Premium
The physician must travel from one location to the patient's home.
The service must be one of the eligible 'Consultations and Visits' or 'Diagnostic and Therapeutic Procedures' listed in the Schedule.
Multiple Resident Dwelling Rule: Only one B990 is eligible for payment regardless of the number of patients seen in one or more living units in a multiple resident dwelling (e.g., apartment block, retirement home, hostel, group home).
A multiple resident dwelling is defined as a single location sharing a common external building entrance or lobby.
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