Q961 – Travel Premium - Weekdays Evenings
OHIP Critical Care Code — GENERAL PREAMBLE · Schedule of Benefits
This premium is for the travel component of a special visit to a patient in a location not otherwise specified (e.g., not a hospital, office, home, or Long-Term Care Institution). To be eligible, the visit must be non-elective and occur on a weekday between 17:00 and 24:00. Key Definitions: - Special Visit: A visit initiated by a patient or their representative for a non-elective service. See for full details. - Travel Premium: Payable for travel from one location to another to provide the service. Only one travel premium is payable per trip, regardless of the number of patients seen. See . - Sacrifice of Office Hours: Occurs when a physician must cancel or delay a scheduled office appointment to attend to a previously unscheduled, non-elective visit. See . This premium is claimed in addition to an appropriate assessment fee (typically an 'A' prefix code) and a 'first person seen' premium (e.g., Q992).
When to Use
- Use Q961 when traveling to a non-professional setting (e.g., a workplace or public venue) for a non-elective, urgent assessment between 17:00 and 24:00 on a weekday.
- Use this code when you must travel to a patient's location that is not a hospital, home, or long-term care facility, provided the visit is initiated by the patient for an urgent, non-elective issue.
Common Pitfalls
- Billing Q961 for patients seen at your own office during evening hours; this is strictly prohibited as the office is a scheduled professional setting.
- Claiming Q961 when the visit occurs at a hospital or long-term care facility, as these locations have their own specific travel premium codes.
- Submitting Q961 for multiple patients on the same trip; only one travel premium is payable per trip, regardless of the number of patients seen.
Billing Tips
- Always pair Q961 with the appropriate 'first person seen' premium, such as Q992, to ensure you are compensated for the travel and the initial assessment fee.
- Ensure your clinical notes explicitly state the time of the visit and the non-elective nature of the request to satisfy audit requirements for special visit premiums.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table IX - Other non-professional setting)
The time at which the special visit takes place must be documented on the medical record.
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