C103 – Travel Premium - Nights
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium payable to specialists in Diagnostic Radiology, Radiation Oncology, or Nuclear Medicine for a non-elective special visit to an acute care hospital to perform or interpret diagnostic services during the night (00:00 - 07:00).
When to Use
- Use C103 when you are physically called into an acute care hospital between 00:00 and 07:00 to perform an urgent, non-elective diagnostic procedure or interpretation.
- Use C103 when you travel to the hospital for an urgent request, but upon arrival and assessment, you determine the procedure is not medically indicated.
Common Pitfalls
- Billing C103 for remote interpretations performed via PACS; this code strictly requires physical travel to the hospital site.
- Attempting to bill C103 in conjunction with emergency department 'H' prefix codes, which is explicitly prohibited by the Schedule.
- Billing C103 for routine hospital rounds or scheduled night shifts, as the service must be a non-elective, urgent special visit.
Billing Tips
- Always pair C103 with C108 for the first patient seen during the visit, and use C106 for any subsequent patients seen during the same trip.
- Ensure your documentation clearly states the time of the call and the clinical necessity of the urgent, non-elective nature of the visit to satisfy audit requirements.
Effective: April 1, 2025
GP. General Preamble
GENERAL PREAMBLE
Special Visit Premium
Premium
The visit must be a 'Special Visit' (initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service).
The request for interpretation or procedure must relate to a patient’s condition requiring urgent interpretation that affects the patient’s management.
The physician must physically travel to the hospital; services rendered outside of a hospital, for example via PACS, are not eligible.
Eligible services include those listed under: Nuclear Medicine, Radiation Oncology, Diagnostic Radiology, Clinical Procedures Associated with Diagnostic Radiology Examinations, Magnetic Resonance Imaging and Diagnostic Ultrasound.
Time period: 00:00 to 07:00.
Payable in addition to the appropriate diagnostic radiology or nuclear medicine consultation, interpretation, or procedural fee.
Payable by itself if a decision is made not to perform the procedure after the physician has traveled to the hospital.
Only one 'person seen' premium (C108 or C106) is eligible per patient regardless of the number of services rendered during the visit.
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