B992 – First person seen - Weekdays Evenings (17:00-24:00) Non-elective
OHIP Paediatrics Code — GENERAL PREAMBLE · Schedule of Benefits
B992 is a special visit premium for the first person seen during a non-elective visit to a patient's home (other than a Long-Term Care Institution). This premium is applicable when the visit is non-elective and occurs on a weekday between 17:00h and 24:00h. This premium must be claimed with an appropriate A-prefix assessment fee from the 'General Listings'.
When to Use
- Bill B992 when you are the first physician to see a patient in their private home after 5 PM on a weekday for an urgent, non-elective reason, and you are billing an appropriate 'A' code assessment.
- Use B992 if your first house call after 5 PM on a weekday is to a patient requiring immediate assessment, and you are billing a code like A003 or A005.
Common Pitfalls
- Claiming B992 for subsequent patients seen during the same house call visit; only the first patient is eligible for this premium.
- Billing B992 for visits to Long-Term Care Institutions, as this premium is specifically for private homes.
- Attempting to bill B992 with A007 or A001 for a home visit, as these specific assessment codes are excluded for home visits when claiming this premium.
Billing Tips
- Ensure the exact time of the house call is documented in the patient's chart to support the weekday evening (17:00-24:00) requirement.
- Remember that B992 is limited to one claim per physician per visit, regardless of how many patients are seen in the same dwelling.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table VI - Special Visits to Patient's Home)
The time at which the special visit takes place must be documented on the medical record.
Special visit to patient's home premiums are only eligible for payment for first patient seen, regardless of number of patients seen during one visit to a home or to one or more living units in a multiple resident dwelling.
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