H980 – First person seen
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
A special visit premium payable for the first patient seen by an 'Emergency Department Physician' (as defined in the Schedule on page ) who is called in for a non-elective service in an Emergency Department or Hospital Urgent Care Clinic. This premium is specifically for services commencing during weekdays between 07:00h and 17:00h. To be eligible, the physician must have been off-site and required to travel to the hospital for the visit, as a travel premium must also be eligible. This 'first person seen' premium is claimed in addition to the appropriate A-prefix assessment fee from the 'General Listings'. It is subject to a combined maximum of 5 'first person seen' (H980) and 'additional person seen' (H981) premiums per physician during this time period.
When to Use
- Use H980 when you are off-site, called in for a non-elective emergency, and are the first patient seen during the 07:00-17:00 weekday window.
- Use this code when you must travel to the hospital to attend an emergency, ensuring you also bill the corresponding H960 travel premium.
Common Pitfalls
- Billing H980 when you are already physically present in the hospital; if you are on-site, you must use the appropriate H-prefix assessment code instead.
- Exceeding the combined maximum of five H980 and H981 premiums per physician during the specified weekday daytime period.
- Failing to document the exact time of the request to attend, which is a mandatory requirement for audit compliance under GP69.
Billing Tips
- Always pair H980 with an appropriate A-prefix assessment fee from the General Listings, as H-prefix assessment codes are restricted when claiming this premium.
- Ensure the travel premium H960 is included on the same claim, as H980 is strictly contingent on the physician being off-site and required to travel.
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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