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C104
C104 – Travel Premium - Sat., Sun. and Holidays
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium payable to specialists in Diagnostic Radiology, Radiation Oncology, or Nuclear Medicine for travel to a hospital to provide non-elective diagnostic services on Saturdays, Sundays, and Holidays between 07:00 and 24:00.
When to Use
- Use C104 when called into the hospital on a weekend or statutory holiday between 07:00 and 24:00 to perform an urgent, non-elective diagnostic interpretation or procedure.
- Use C104 when you are required to travel to the hospital to assess an emergency department or in-patient case that cannot wait until the next business day.
Common Pitfalls
- Billing C104 for services performed between 00:00 and 07:00 on a weekend or holiday; these must be billed as C103 (Nights).
- Attempting to claim C104 for travel between different buildings if they are considered part of the same hospital complex or campus.
- Submitting C104 for elective procedures or routine rounds, which are explicitly excluded from special visit premium eligibility.
Billing Tips
- Always pair C104 with C110 for the first patient seen to maximize the premium value for the trip.
- Ensure the medical record clearly documents the time of the request and the time of arrival at the hospital to justify the special visit status during an audit.
Provider Fee$0.00
Specialist Fee$36.40
Effective: April 1, 2025
Category
GP. General Preamble
Subcategory
GENERAL PREAMBLE
Service Type
Special Visit Premium
Code Classes
Premium
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