H963 – Travel Premium
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
Payable for travel to an Emergency Department for a special visit by an 'Emergency Department Physician' (as defined on ). This premium applies when the service is rendered on a Saturday, Sunday, or Holiday between 07:00 and 24:00. A special visit is initiated by a patient or on their behalf for a non-elective service. Only one travel premium is payable per trip, regardless of the number of patients seen. This premium must be claimed with an appropriate 'A' prefix assessment code.
When to Use
- Use H963 when you are called in from home to the Emergency Department on a Saturday, Sunday, or Holiday between 07:00 and 24:00 to attend to a non-elective patient.
- Use H963 as the mandatory prerequisite travel premium when billing H988 for the first patient seen during that specific call-in event.
Common Pitfalls
- Billing H963 when you are already physically present in the hospital for other duties, as this is restricted and should instead be billed using the appropriate H-prefix codes.
- Attempting to bill H963 alongside emergency department H-prefix codes, which are strictly prohibited as H963 requires an A-prefix assessment code.
- Claiming multiple H963 premiums for a single trip where multiple patients are seen; only one travel premium is payable per trip regardless of patient volume.
Billing Tips
- Always pair H963 with an A-prefix assessment code and the H988 'first person seen' premium to ensure the full value of the special visit is captured.
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.
Emergency Department by Emergency Department Physician (as defined on )
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