W960 – Travel Premium - Long-Term Care Institution
OHIP Neurology Code — GENERAL PREAMBLE · Schedule of Benefits
W960 is a travel premium payable for a non-elective special visit to a patient in a Long-Term Care Institution. It applies to visits on weekdays (Monday to Friday) between 07:00 and 17:00. A special visit is defined as one initiated by a patient or an individual on behalf of the patient for the purpose of rendering a non-elective service (). This premium covers the travel from one location to another and must be claimed with an appropriate 'A'-prefix assessment fee (). It is not payable for travel between locations within the same facility complex () or for routine rounds ().
When to Use
- Use W960 when you are called to a long-term care facility during business hours for an urgent, non-elective assessment that was not part of your pre-scheduled routine rounds.
- Use this code when traveling from your primary office or another facility to a long-term care home specifically to address an acute change in a patient's condition.
Common Pitfalls
- Claiming W960 for routine rounds or pre-planned visits is a common audit trigger; the visit must be initiated by the patient or staff for an urgent, non-elective issue.
- Billing W960 for travel between different wings or buildings within the same long-term care complex is prohibited under GP66 and will result in rejection.
- Failing to link W960 with a valid A-prefix assessment code (e.g., A007) will cause the claim to be rejected as the premium cannot stand alone.
Billing Tips
- Ensure the exact time of the visit is documented in the patient's chart, as this is required to justify the non-elective nature and the specific time-based premium.
Effective: April 1, 2026
GP. General Preamble
GENERAL PREAMBLE
Premium
Special Visit Premiums (Table IV - Long-Term Care Institution)
The time at which the special visit takes place must be documented on the medical record.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.