W961 – Travel Premium - Weekdays Evenings
OHIP Neurology Code — GENERAL PREAMBLE · Schedule of Benefits
W961 is a travel premium of $37.40 payable for a non-elective special visit to a patient in a Long-Term Care Institution, as defined in . This premium is subject to the following conditions: - The visit must occur on a weekday (Monday to Friday) between 17:00 and 24:00. The premium compensates for the travel to the institution and is not payable for travel between different locations within the same facility or campus. Only one travel premium is payable per trip, irrespective of the number of patients seen (). Claims for assessments rendered with a special visit premium should use the appropriate A-prefix assessment fee from the General Listings ().
When to Use
- Use W961 when you are called to a long-term care facility for an urgent, non-elective assessment between 17:00 and 24:00 on a weekday.
- Use W961 when responding to an acute change in patient status that requires an immediate, unscheduled visit that cannot wait until your next routine round.
Common Pitfalls
- Billing W961 for routine or elective follow-up visits, which must be billed as standard subsequent visit codes rather than special visits.
- Attempting to claim W961 for multiple patients seen during the same trip; the travel premium is only payable once per trip regardless of the number of patients assessed.
- Submitting W961 when already present in the facility for routine rounds, as the premium is intended to compensate for the travel specifically initiated for the non-elective visit.
Billing Tips
- Always pair W961 with the appropriate A-prefix assessment code (e.g., A007) to ensure the claim is processed correctly under the General Listings.
- Ensure the exact time of the visit is clearly recorded in the patient's chart, as this is a mandatory audit requirement for all special visit premiums.
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. Sourced from .
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.