H964 – Travel Premium
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
This premium is payable for the travel associated with a special visit to an Emergency Department by a physician who meets the specific criteria for an 'Emergency Department Physician' as defined on page . It is applicable when the visit commences during the night, between 00:00 and 07:00. This premium is claimed in conjunction with an appropriate A-prefix assessment code and a 'first person seen' or 'additional person seen' premium. The service must be non-elective and meet all requirements for special visits.
When to Use
- Use H964 when you are an Emergency Department Physician called back to the hospital from off-site to attend a non-elective patient between 00:00 and 07:00.
- Use it when you are required to travel to the ED for a patient assessment that cannot wait until your next scheduled shift, provided you meet the criteria in GP67.
Common Pitfalls
- Claiming H964 when you are already physically present in the hospital; if you are on-site, you are not eligible for travel premiums and should look to H-prefix codes instead.
- Attempting to bill H964 with H-prefix emergency department codes, which is explicitly prohibited by the General Preamble.
- Failing to document the specific time the request to attend was received, which is a mandatory audit requirement for all Table V special visit premiums.
Billing Tips
- Always pair H964 with the appropriate A-prefix assessment code (e.g., A007) and either H986 for the first patient or H987 for subsequent patients.
- Ensure your claim includes the exact time of the request to attend, as this is the primary data point used to verify the 'special visit' status and night-time eligibility.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table V - Emergency Department by Emergency Department Physician)
For fee codes listed in Special Visit Premium Table V, the following must be documented on the medical record: - the time of the request to attend in the emergency department. - the specific situation requiring the physician's attendance.
This premium is for travel for a special visit to the Emergency Department by an Emergency Department Physician as defined on .
This premium applies for services rendered during Nights (00:00-07:00).
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.