C962 – Travel premium - Hospital In-Patient - Sat., Sun. and Holidays
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
C962 is a travel premium payable for a special visit to a hospital in-patient, as defined in . 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. This premium is applicable when a physician must travel to a hospital to provide a non-elective service. The service must commence on Saturdays, Sundays, or Holidays between 00:00 and 24:00. This premium is claimed in addition to an appropriate A-prefix assessment fee. Only one travel premium is payable per trip, regardless of the number of patients seen. It is not payable for travel within the same hospital complex. The time of the visit must be documented in the medical record. See to for complete rules on Special Visit Premiums.
When to Use
- Use C962 when you are called into the hospital on a weekend or holiday specifically to assess an in-patient for a non-elective issue that cannot wait until your next scheduled rounds.
- Apply this code when you travel from your home or office to the hospital to provide an urgent service, provided the service commences on a Saturday, Sunday, or statutory holiday.
Common Pitfalls
- Do not bill C962 if you are already at the hospital for other scheduled work; the premium is strictly for a separate trip initiated by a request for a non-elective service.
- Avoid billing C962 for travel between different buildings if they are considered part of the same hospital complex, as this does not meet the definition of a travel premium trip.
- Failing to document the exact start time of the visit in the patient's chart will lead to automatic rejection or clawbacks during an audit.
Billing Tips
- Always pair C962 with the appropriate 'C' prefix assessment code and the 'C994' first person seen premium to maximize the reimbursement for the initial patient encounter.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table III - Hospital In-Patient)
The time at which the special visit takes place must be documented on the medical record.
A special visit means a visit initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service or, if rendered in the patient's home, a non-elective or elective service.
Special visit premiums are in respect of either or both: a "travel premium" and a "patient seen" premium (i.e. "first person seen premium" or "an additional person seen premium").
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