H988 – First person seen - Emergency Department Physician - Sat., Sun. and Holidays
OHIP Obstetrics Code — GENERAL PREAMBLE · Schedule of Benefits
This is a 'first person seen' special visit premium. A special visit is a visit initiated by a patient or an individual on behalf of a patient for the purpose of rendering a non-elective service (). This premium is specifically for an 'Emergency Department Physician' as defined on . This premium is eligible for payment for services rendered on Saturdays, Sundays, and Holidays (07:00-24:00). It is payable in addition to an appropriate assessment fee from the General Listings ('A' prefix). Per commentary on , this premium is eligible for payment only when the physician is required to travel to make a special visit to the hospital emergency department.
When to Use
- Use H988 when you are off-site and must travel to the Emergency Department specifically to attend to a non-elective patient on a weekend or holiday.
- Use H988 for the first patient seen during a special visit, provided the service is initiated by a request from the emergency department staff for your immediate attendance.
Common Pitfalls
- Billing H988 when you are already physically present in the hospital for other duties, as the premium requires a specific travel event to the facility.
- Exceeding the combined maximum of 10 services for H988 and H989 per weekend or holiday period, which will trigger automatic rejections.
- Failing to document the exact time of the request to attend, which is a mandatory requirement for audit compliance under GP69.
Billing Tips
- Ensure you pair H988 with the appropriate 'A' prefix assessment code (e.g., A405) to ensure the claim is processed correctly as a special visit.
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.
Payable to an Emergency Department Physician as defined on .
Maximum 10 total of first and additional person seen (H989) per time period.
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