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C960

C960Travel premium

OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits

A travel premium that is eligible for payment for travel from one location to another to render a non-elective service to a hospital in-patient. This premium applies to visits on weekdays (Monday to Friday) between 07:00 and 17:00. A special visit is a visit initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service. Only one travel premium is eligible for payment for each separate trip to a destination, regardless of the number of patients seen.

When to Use

  • Use C960 when you are called to a hospital in-patient unit from your office or home between 07:00 and 17:00 on a weekday for a non-elective assessment.
  • Apply this code when you must travel between two distinct hospital campuses that are not part of the same complex to see an in-patient for an urgent, non-elective issue.

Common Pitfalls

  • Billing C960 when traveling between buildings on the same hospital campus is a common audit trigger and will result in a rejection.
  • Attempting to bill C960 for multiple patients seen during the same trip is prohibited; you may only claim the travel premium once per trip regardless of the number of patients assessed.
  • Submitting C960 for elective follow-ups or routine rounds is incorrect, as the service must be initiated by the patient or staff for a non-elective, urgent need.

Billing Tips

  • Always pair C960 with the appropriate A-prefix assessment code (e.g., A007) and ensure the exact start time of the visit is documented in the patient's chart to satisfy GP69 requirements.
Provider Fee$37.40

Effective: April 1, 2026

Category

GP. General Preamble

Subcategory

GENERAL PREAMBLE

Service Type

Premium

Code Classes

Special Visit Premiums (Table III - Hospital In-Patient)

For fee codes listed in Tables I, II, III, IV, VI, VII, VIII, IX and X the time at which the special visit takes place must be documented on the medical record.

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