C985 – Special visit premium, anaesthesia services, Saturdays, Sundays or Holidays daytime and evenings (07:00h - 24:00h)
OHIP Surgical Procedures Code · Schedule of Benefits
A special visit premium payable to an anaesthesiologist who is required to travel to a hospital to administer an anaesthetic for a case that commences on Saturdays, Sundays, or Holidays during the daytime or evening (07:00h - 24:00h). This premium is only eligible for the first patient seen on each special visit.
When to Use
- Use C985C when you are called in from home to the hospital on a weekend or holiday to provide anaesthesia for an urgent or emergent surgical procedure.
- Apply this code when the case commences between 07:00 and 24:00 on a Saturday, Sunday, or statutory holiday, provided you were not already on-site for scheduled duties.
Common Pitfalls
- Billing C985C for subsequent patients seen during the same trip to the hospital; it is strictly limited to the first patient per special visit.
- Submitting C985C for patients seen during routine hospital rounds or elective cases, which are explicitly excluded from special visit premium eligibility.
- Attempting to claim C985C in conjunction with emergency department 'H' prefix codes, which will trigger an automatic rejection.
Billing Tips
- Always pair C985C with the appropriate anaesthesia base unit code and the E400C after-hours premium to maximize the claim value for weekend/holiday work.
- Ensure your documentation clearly reflects the time of the call and the time of arrival at the hospital to substantiate the 'special visit' requirement in the event of an audit.
Effective: April 1, 2025
Anaesthesiologists' Services
Premium
Special visit premiums are not eligible for payment for services rendered to patients who present to an office without an appointment while the physician is there, or for patients seen immediately before, during, or after routine office hours.
Only one travel premium is eligible for payment for each separate trip to a destination regardless of the number of patients seen.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.