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E413 – Emergency Department Physician - Nights

OHIP General Preamble Code — GENERAL PREAMBLE · Schedule of Benefits

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Billed by time of day

ED physician procedure premium. Percentage premium on eligible procedures, by when the procedure starts.. Toronto time.

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ED physician procedure premium by time period
Weekday daytimeMon–Fri 07:00–17:00No code
Weekday eveningMon–Fri 17:00–24:00
NightEvery day 00:00–07:00
  • E413(this code)+40%
Weekend or holidaySat, Sun & holidays 07:00–24:00
An after-hours premium that increases the procedural fee by 40% for services provided by an Emergency Department Physician. This premium is payable only when specific procedures are performed during the night, between 00:00h and 07:00h. Conditions for Payment: This premium is payable only when the following criteria are met: a. The service provided is one of the following: • Non-elective Surgical Procedures (including fractures or dislocations) • Obstetrical Deliveries • Clinical Procedures Associated with Diagnostic Radiological Examinations • Ground Ambulance Transfer (K101) • Air Ambulance Transfer (K111) • Transport of Donor Organs (K102) • Return Trip (K112) • One of the listed Major Invasive Procedures (see applicable codes) • X112 when required for intussusception and; b. The procedure is either: • (a) non-elective; or • (b) an elective procedure which, because of an intervening surgical emergency procedure(s), was delayed and commenced between 00:00h and 07:00h.
E412E409E410

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