C102 – Travel Premium
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium for a special visit to provide non-elective diagnostic services. Eligibility: - Physician: Specialists in Diagnostic Radiology (33), Radiation Oncology (34), or Nuclear Medicine (63). - Location: Service must be rendered to an acute care hospital in-patient, out-patient, or emergency department patient. - Time: The visit must be during weekday evenings, from 17:00h to 24:00h. - Service Type: The visit must be for a non-elective purpose, such as interpreting diagnostic results, performing a procedure, rendering a diagnostic radiology or nuclear medicine consultation, or concluding a procedure is not medically indicated. The request must relate to a patient's condition requiring urgent interpretation that affects the patient's management. - Applicable Services: This premium is payable with services from the following sections: - Nuclear Medicine - Radiation Oncology - Diagnostic Radiology - Clinical Procedures Associated with Diagnostic Radiological Examinations - Magnetic Resonance Imaging (MRI) - Diagnostic Ultrasound Payment Rules & Limitations: - This premium is for travel to the hospital and is not eligible for payment for services rendered remotely (e.g., via PACS) or for travel within the same hospital complex. - This premium is not eligible for payment in addition to any other special visit premium for the same special visit. - General special visit rules from - apply.
When to Use
- Use C102 when you are physically called back to the hospital between 17:00 and 24:00 on a weekday to perform an urgent, non-elective diagnostic procedure or interpretation that directly alters patient management.
- Apply this code when you must travel to the hospital to perform an urgent ultrasound or nuclear medicine scan that cannot wait until the next business day.
Common Pitfalls
- Billing C102 for remote interpretations performed via PACS is a common audit trigger, as this premium strictly requires physical travel to the hospital site.
- Attempting to claim C102 alongside 'H' prefix emergency department codes (e.g., H100-H153) will result in automatic rejection due to billing restrictions.
- Claiming C102 for travel between buildings on the same hospital campus is ineligible; the premium only applies when traveling from outside the hospital complex.
Billing Tips
- Ensure the exact time of the visit is documented in the patient record, as this is mandatory to justify the 'special visit' status and the evening time window.
- If you see multiple patients during one trip, ensure you are only billing the travel premium for the first patient and using the appropriate 'additional patient' premium for subsequent patients to avoid duplicate travel claims.
Effective: April 1, 2025
GP. General Preamble
GENERAL PREAMBLE
Premium
Other Premiums (including After Hours Procedure Premiums), Special Visit Premiums (Table III - Hospital In-Patient)
The time at which the special visit takes place must be documented on the medical record.
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