H984 – First person seen - Emergency Department Physician - Evenings
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
This is a special visit premium for the first person seen by an Emergency Department Physician (as defined on ) in an Emergency Department. This premium is applicable for non-elective services that commence between 17:00h and 24:00h, Monday through Friday. To be eligible, the physician must be requested by the emergency department to attend at a time when they are not otherwise scheduled to work and are not at the hospital when the request is made (). This premium requires travel to the hospital. Claims for special visit premiums must be submitted with an appropriate A-prefix assessment fee from the 'General Listings' () and cannot be billed with 'H' prefix emergency department service codes (). The fee for this premium is $60.00 as per the Special Visit Premium Table V.
When to Use
- Use H984 when you are called in from home to the Emergency Department between 17:00 and 24:00 on weekdays to attend a non-elective patient.
- Use this code when you are not already on-site at the hospital and are specifically requested by the ED to attend a patient, provided you are the first person seen.
Common Pitfalls
- Billing H984 alongside 'H' prefix ED codes (e.g., H072) will result in an automatic rejection; you must use an 'A' prefix assessment code (e.g., A007) instead.
- Claiming this premium while already present in the hospital for other duties is a common audit trigger, as the premium specifically requires travel from outside the facility.
Billing Tips
- Ensure your documentation explicitly records the time of the request to attend and the clinical necessity, as these are mandatory for audit compliance under GP69.
- If you see subsequent patients after the first, remember that H984 only applies to the first person seen, while subsequent patients should be billed with the appropriate 'A' prefix code and the H985 travel premium.
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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