C987 – Additional person(s) seen
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
C987 is a premium payable for each additional patient seen by a physician during a special visit to a hospital in-patient during weekdays daytime (07:00-17:00) with sacrifice of office hours. This premium is paid in addition to the appropriate assessment fee (which must be claimed with an 'A' prefix as per ). It applies after the 'first person seen' premium (C986) has been claimed for the visit. A special visit is defined as a non-elective service initiated by or on behalf of a patient (). This premium is not payable for: - Patients seen during routine hospital rounds. - Admission assessments for patients admitted on an elective basis. - Visits for which critical care team fees are payable. - Services rendered with emergency department 'H' prefix fee codes.
When to Use
- Use C987 for the second and every subsequent patient seen during the same hospital trip where you have already claimed C986 for the first patient.
- Apply this code when you are called in for a non-elective, urgent assessment of a second inpatient during the 07:00-17:00 weekday window while sacrificing office time.
Common Pitfalls
- Claiming C987 for routine hospital rounds or elective admissions, which are explicitly excluded under the General Preamble.
- Billing C987 without an associated A-prefix assessment code, as the premium is only payable when linked to a valid service fee.
- Attempting to claim C987 for patients seen in the Emergency Department, as special visit premiums for ED patients must use the H-prefix codes.
Billing Tips
- Ensure the start time of the service for each additional patient is clearly documented in the chart to justify the non-elective nature and the sequence of the special visit.
- Always verify that the first patient of the trip is billed with C986; C987 is strictly for the 'additional' patients seen thereafter.
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.
An additional person premium is only eligible for payment for services rendered at the destination to additional patients seen as hospital in-patients, provided that each additional patient service is commenced during the eligible times ().
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