K962 – Travel Premium
OHIP Consultation & Visit Premium Codes Code — GENERAL PREAMBLE · Schedule of Benefits
K962 is a travel premium payable for a special visit to a patient in an Emergency Department. A special visit is a visit initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service (see ). This premium applies to travel for services rendered during the evening (17:00-24:00) on weekdays (Monday through Friday). As per , a travel premium is only eligible for payment for travel from one location to another ('the destination'). It is not eligible for payment when a physician travels within the same hospital complex or within buildings on the same hospital campus. Only one travel premium is eligible for payment for each trip to a destination, regardless of the number of patients seen. This premium is part of the Special Visit Premium Table I and is explicitly not eligible for payment to physicians who meet the definition of an 'Emergency Department Physician' (see ).
When to Use
- Use K962 when you are called from home or your office to the Emergency Department for a non-elective consultation or assessment between 17:00 and 24:00 on a weekday.
- Use K962 when attending an emergency patient in the ED that requires a dedicated trip, provided you are not an Emergency Department Physician as defined in GP67.
Common Pitfalls
- Billing K962 when you are already physically present in the hospital for other duties, as the travel premium requires a distinct trip from an outside location.
- Attempting to claim K962 when seeing patients in the ED while already on-site for routine rounds or scheduled clinic hours, which violates the 'sacrifice of office hours' requirement.
- Claiming multiple K962 premiums for a single trip if you see multiple patients; only one travel premium is permitted per trip regardless of patient volume.
Billing Tips
- Always pair K962 with the appropriate 'First Person Seen' premium (K994) to maximize the value of the non-elective emergency visit.
- Ensure your documentation clearly records the time the call was received and the time you arrived at the ED to substantiate the travel claim during an audit.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table I - Emergency Department)
The time at which the special visit takes place must be documented on the medical record.
*Not eligible for payment to Emergency Department Physicians (see definition )*
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