Q962 – Travel Premium - Daytime Sat., Sun. and Holidays
OHIP Critical Care Code — GENERAL PREAMBLE · Schedule of Benefits
A travel premium for a special visit to a patient in a setting not otherwise listed in the special visit premium tables. This premium is applicable when a physician travels to render a non-elective service that commences between 07:00 and 24:00 on a Saturday, Sunday, or Holiday. A special visit is defined as a visit initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service. Only one travel premium is payable for each separate trip to a destination, regardless of the number of patients seen. The time of the visit must be documented in the medical record. Submit claims using the appropriate A-prefix assessment fee from the 'General Listings' for the assessment rendered in conjunction with this special visit premium.
When to Use
- Use Q962 when you are called to a patient's private residence on a weekend or holiday for an urgent, non-elective assessment that requires a dedicated trip.
- Apply this code when traveling to a non-professional setting, such as a workplace or public location, for an urgent assessment that falls outside of your standard office hours.
Common Pitfalls
- Billing Q962 for patients seen during routine weekend office hours will result in rejection, as the service must be a special trip initiated by the patient, not a scheduled clinic session.
- Claiming Q962 alongside hospital-based premiums like H102 is prohibited; the code is strictly for settings not covered by the standard Special Visit Premium tables.
- Failure to document the exact start time of the visit in the clinical note is a common audit trigger that leads to full clawbacks of the premium.
Billing Tips
- Ensure you pair Q962 with the appropriate A-prefix assessment code (e.g., A007) to satisfy the requirement for a rendered assessment fee.
- If you see multiple patients at the same non-professional location during one trip, you can only claim Q962 once, though you may bill the assessment fee for each patient seen.
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.
This premium is for travel to a non-professional setting not otherwise listed in the Special Visit Premium tables.
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