H962 – Travel Premium
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
This is a travel premium payable for a special visit to an Emergency Department by an Emergency Department Physician, as defined on page . It applies when the physician is not at the hospital and is requested to attend for a non-elective service that commences during the evening (17:00h - 24:00h) on a Monday through Friday. This premium is for travel from one location to another to see the patient. See pages to for full details on Special Visit Premiums.
When to Use
- Use H962 when you are off-site and called back to the Emergency Department for a non-elective patient assessment between 17:00 and 24:00 on a weekday.
- Apply this code in conjunction with an A-prefix assessment fee (e.g., A485) when you must physically travel to the hospital specifically to address an urgent patient need.
Common Pitfalls
- Billing H962 when you are already physically present in the hospital or Emergency Department at the time of the request is a common audit trigger for recovery.
- Attempting to claim H962 for elective services or routine follow-ups will result in automatic rejection as the service must be non-elective.
- Failure to document the exact time of the request to attend is a frequent cause for claim rejection during manual audits.
Billing Tips
- Ensure the time of the request and the clinical necessity for the special visit are clearly noted in the chart to satisfy the documentation requirements outlined in GP69.
- Only claim H962 if you are not covered by an ED-AFA, as physicians under Alternate Funding Arrangements are generally ineligible for these fee-for-service premiums.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table V - Emergency Department by Emergency Department Physician)
The time of the request to attend in the emergency department must be documented on the medical record.
The specific situation requiring the physician's attendance must be documented on the medical record.
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