U992 – First person seen - Weekdays Evenings
OHIP Other Code — GENERAL PREAMBLE · Schedule of Benefits
U992 is a 'first person seen' special visit premium payable for a visit to a hospital out-patient department. It is only eligible for payment under the following conditions: - The service is for the first person seen during a special visit. - The visit takes place on a weekday (Monday to Friday) during evening hours (17:00h to 24:00h). A special visit is defined as a visit initiated by a patient or on their behalf for a non-elective service (see ). This premium must be claimed with an appropriate A-prefix assessment fee from the General Listings (see ). The time of the visit must be documented in the medical record.
When to Use
- Use U992 when you are called to the hospital outpatient department for a non-elective, urgent assessment between 17:00 and 24:00 on a weekday.
- Use this code for the first patient seen during an urgent, non-elective visit that requires you to travel specifically to the hospital outside of your routine office hours.
Common Pitfalls
- Billing U992 for patients seen during routine hospital rounds or elective admissions, which are explicitly excluded under the General Preamble.
- Claiming U992 when the hospital outpatient department is already scheduled to be open for the purpose of treating patients, as this does not constitute a 'special visit'.
- Failing to document the exact time of the visit in the medical record, which is a mandatory requirement for all Table II special visit premiums.
Billing Tips
- Always pair U992 with an appropriate A-prefix assessment code (e.g., A007) to ensure the premium is triggered correctly.
- If you see subsequent patients during the same special visit, use U993 for the additional patients to maximize the claim value.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table II - Hospital Out-Patient Department)
For fee codes listed in Table II, the time at which the special visit takes place must be documented on the medical record. When a special visit service occurs in a hospital where common medical records are maintained, the time when the visit takes place may be documented anywhere in the common medical record.
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