All codes
B998
B998 – First person seen
OHIP Paediatrics Code — GENERAL PREAMBLE · Schedule of Benefits
A special visit premium payable for the first person seen during a palliative care home visit to a terminally ill patient in their final year of life.
When to Use
- Use B998 when performing an A007 intermediate assessment for a palliative patient in their home during daytime or evening hours.
- Apply B998 when you are the first physician to arrive at the patient's home for a palliative visit, provided the visit is not part of routine rounds.
Common Pitfalls
- Billing B998 alongside B997 for the same visit is a common error; B997 is exclusively for night visits (00:00-07:00) and replaces B998.
- Submitting B998 for a patient in a facility that is considered a 'place scheduled to be open' will result in a rejection, as it is strictly for home-based palliative care.
- Attempting to claim B998 with an 'H' prefix code (e.g., H007) will trigger an automatic rejection as these are mutually exclusive.
Billing Tips
- Always pair B998 with the B966 travel premium to maximize the reimbursement for the time and distance spent traveling to the patient's home.
Provider Fee$91.80
Effective: April 1, 2026
Since Oct 2005, this fee has increased 43.9% vs 52.9% CPI inflation
Category
GP. General Preamble
Subcategory
GENERAL PREAMBLE
Service Type
Special Visit Premium
Code Classes
Premium
The time of the visit must be documented in the medical record
Must be the first person seen at the destination
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