C998B – Evenings (17:00h - 24:00h) Monday to Friday, first patient seen
OHIP Surgical Procedures Code — GENERAL PREAMBLE · Schedule of Benefits
A special visit premium payable when a physician is required to travel to assist at a non-elective surgery. This premium is for the first patient seen when the service commences during the evening (17:00h to 24:00h), Monday to Friday. Payment is contingent on the physician traveling from one location to another as defined on page . This premium can be claimed in addition to the after-hours premiums E400B and E401B.
When to Use
- Use C998B when you are called in to assist with a non-elective surgery and must travel from your office or home to the hospital between 17:00 and 24:00 on a weekday.
- Claim this code for the first patient seen during an emergency surgical call-out that meets the travel requirement, distinct from the surgical assistant fee itself.
Common Pitfalls
- Claiming C998B without documented proof of travel from a separate location, as this is a strict requirement for all special visit premiums under the General Preamble.
- Attempting to bill C998B for elective surgeries, which are explicitly excluded from the definition of this special visit premium.
- Confusing C998B with E400B; remember that C998B is a travel-based special visit premium, while E400B is a percentage-based premium on the surgical assistant fee.
Billing Tips
- Always document the exact time the service commenced and the location you traveled from, as these are the primary audit points for C998B.
- Ensure you stack C998B with the appropriate surgical assistant fee and the E400B after-hours premium to maximize the claim for emergency evening procedures.
No fee information available.
GP. General Preamble
GENERAL PREAMBLE
Premium
Surgical Assistants' Services, Special Visit Premiums (Table III - Hospital In-Patient)
The time at which the special visit takes place must be documented on the medical record.
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