Q963 – Travel Premium - Nights
OHIP Critical Care Code — GENERAL PREAMBLE · Schedule of Benefits
This is a travel premium for a special visit to a location that is not a professional setting and not otherwise specified in other special visit tables (e.g., hospital, office, home). This premium is payable for a visit during Nights (00:00h and 07:00h). 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 eligible for payment for each separate trip to a destination, regardless of the number of patients seen. This premium must be claimed with an appropriate 'A' prefix assessment fee. Refer to the Special Visit Premiums section starting on for complete eligibility criteria and restrictions.
When to Use
- Use Q963 when you are called out to a non-professional setting, such as a patient's residence or a community site, for an urgent, non-elective assessment between 00:00 and 07:00.
- Apply this code when the service is initiated by the patient or their representative specifically for an urgent issue that cannot wait until regular office hours.
Common Pitfalls
- Billing Q963 for patients seen at a hospital or long-term care facility, which are explicitly excluded; use the Q99x series for those settings instead.
- Claiming Q963 when the visit occurs immediately before or after your scheduled office hours, as the General Preamble prohibits premiums for services rendered during or adjacent to routine hours.
- Attempting to bill multiple travel premiums for the same trip if you see more than one patient; Q963 is restricted to one premium per trip regardless of the number of patients seen.
Billing Tips
- Always pair Q963 with an appropriate 'A' prefix assessment code (e.g., A007) to ensure the claim is processed correctly as a special visit.
- Document the exact time of the visit in the patient record, as this is a mandatory requirement to justify the 'Night' time period eligibility.
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.
Submit claims using the appropriate A-prefix assessment fee from the “General Listings” for an assessment rendered in conjunction with a special visit premium.
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