Q994 – First person seen - Daytime Sat., Sun. and Holidays
OHIP Critical Care Code — GENERAL PREAMBLE · Schedule of Benefits
This premium, Q994, is for the first person seen during a special visit to a non-professional setting not otherwise listed in the Schedule of Benefits. As per , a special visit is a non-elective service initiated by a patient or their representative. This specific premium applies when the visit commences on Saturdays, Sundays, or Holidays during daytime hours of 07:00 to 24:00. It is claimed in addition to an appropriate assessment fee, typically an 'A' prefix code from the General Listings, as instructed on . The time of the visit must be documented in the medical record.
When to Use
- Use Q994 when you are called to a patient's home or a nursing home on a weekend or holiday for an urgent, non-elective assessment.
- Use this code for the first patient seen during an urgent, non-elective visit to a non-professional setting where you were not already scheduled to be present.
Common Pitfalls
- Claiming Q994 for patients seen in your office during hours you are already present, which violates the requirement that the visit must be a special, non-elective trip.
- Failing to document the exact start time of the visit, which is a mandatory requirement for all special visit premiums under GP69.
- Attempting to bill Q994 for subsequent patients seen during the same trip, as this code is strictly for the 'first person seen' only.
Billing Tips
- Always pair Q994 with an appropriate A-prefix assessment code (e.g., A007) to ensure the claim is processed correctly as a special visit.
- If you see additional patients during the same special visit, use Q998 for the second and subsequent patients instead of repeating Q994.
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 the 'first person seen'.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.