U962 – Travel Premium - Sat., Sun. and Holidays
OHIP Other Code — GENERAL PREAMBLE · Schedule of Benefits
U962 is a special visit travel premium. It is payable for travel to a hospital out-patient department to render a non-elective service to a patient. The service must commence on a Saturday, Sunday, or Holiday (07:00-24:00). This travel premium is limited to a maximum of 2 per time period. As per , special visits are initiated by a patient or on their behalf for a non-elective service. This premium is claimed in addition to an appropriate 'A' prefix assessment code from the General Listings as per . As per , a travel premium is only eligible for travel between different locations, not within the same hospital complex, and only one travel premium is payable per trip regardless of the number of patients seen.
When to Use
- Use U962 when you travel from your office or home to a hospital out-patient department to provide a non-elective service on a weekend or holiday.
- Use this code when the service is initiated by a patient or on their behalf, such as an urgent consultation requested by the emergency department or a ward physician for an out-patient.
Common Pitfalls
- Claiming U962 for travel within the same hospital complex, which is strictly prohibited by GP66; use only the 'first person seen' premium (U994) in these cases.
- Attempting to claim U962 for patients seen during routine rounds, as special visit premiums are specifically restricted for scheduled or routine hospital care.
- Submitting U962 for elective services or walk-in patients seen during or near your regular office hours, which will trigger an audit or rejection.
Billing Tips
- Always pair U962 with the appropriate A-prefix assessment code (e.g., A007) and the applicable 'first person seen' premium (U994) to maximize the claim for the initial patient.
- Ensure the exact time of the service is documented in the chart, as this is the primary verification point for the non-elective nature and timing of the special visit.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table II - Hospital Out-Patient Department)
The time at which the special visit takes place must be documented on the medical record.
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