H113 – Premium - daytime and evenings (Saturdays, Sundays, Holidays and Friday Evenings)
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
The H113 premium is applied per patient visit when an Emergency Department Physician renders a service, other than an assessment, on a Saturday, Sunday, or Holiday between 08:00h and 24:00h or on Friday Evenings between 17:00h and 24:00h. Per page , an 'Emergency Department Physician' is a physician working in a hospital emergency department or a Hospital Urgent Care Clinic for the purpose of rendering services to unscheduled patients. This premium cannot be claimed in conjunction with any assessment codes (e.g., H101 to H154). It is payable with other services, such as procedures. Note that most ultrasound services rendered by an Emergency Department Physician are not eligible for payment, except for ultrasound guidance (J149) or emergency department investigative ultrasound (H100).
When to Use
- Use H113 when performing a minor procedure, such as a simple laceration repair (e.g., G365), during the specified weekend or Friday evening hours.
- Apply H113 when providing an emergency department investigative ultrasound (H100) on a Saturday, Sunday, or holiday within the eligible time window.
Common Pitfalls
- Billing H113 alongside any assessment code (H101-H154) will result in an automatic rejection as the premium is strictly for non-assessment services.
- Attempting to claim H113 for services rendered outside of the Friday 17:00-24:00 or weekend 08:00-24:00 windows will lead to claim adjustment.
Billing Tips
- Ensure the procedure code billed with H113 is not an assessment code, as H113 is designed specifically to supplement procedural work performed in the ED during premium hours.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Premium
Other Premiums (including After Hours Procedure Premiums)
When any other service is rendered by the Emergency Department Physician in premium hours (and assessments may not be claimed), apply one of the following premiums per patient visit.
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