OHIP Special Visit Premiums


OHIP special visit premiums act like a bonus on top of regular fee codes and are incentives for physicians who have specific specialties or sub-specialties. You’ll also benefit from them if you work on weekends, late at night or on holidays. Therefore, they’re a great way to increase your monthly revenue!

However, while they do exist to make sure that you’re compensated for the extra work you do, there are several guidelines you need to know in order to use and benefit from them properly.  

General Guidelines for OHIP Special Visit Premiums

In order to make sure you qualify and are using OHIP premiums properly, we’ve outlined all the rules and guidelines below. For a printable version click here.

OHIP Special Visit Premium Rules

  • May only be applied with non-elective (urgent and emergent) consults and assessments.

  • May not be claimed for routine rounds.

  • May not be claimed for visits to admit elective patients.

  • Special visit premiums do not apply to subsequent hospital inpatient visits.

  • Visit fees and related premiums must be kept together on the SAME bill.

  • Always use the “A” prefix general listing visit codes.  

    Billing Tip: Only use the A prefix consult and visit fees and not C prefix codes. The “C” prefix consult codes are strictly for non-emergency inpatient consults (and therefore no special visits apply). Our billing agents see this error ALL the time! 


OHIP Special Visit Premiums can be used in 3 scenarios:

Travel Premium First Patient Seen Additional Person(s) Seen
When you travel from any place other than the hospital where the service is performed. Applies only to your first patient. (If your shift goes past midnight, you can bill it again). Applies to each additional patient after you’ve billed your first patient.


They are categorized into 5 different time brackets:

Weekdays Mon. - Fri. "Sacrifice of Office hours") Evenings (Monday - Friday) Weekends & Holidays Nights
07:00 - 17:00 07:00 - 17:00 17:00 - 24:00 07:00 - 24:00 0:00 - 7:00

Note: “Sacrifice of Office” is when you have an unscheduled visit to Emergency or Hospital In-patient during regular office hours.


OHIP Special Visit Premiums (separated by department): 

Each department below displays the scenario (on the left), the time bracket (above), and then:

The fee code
The amount of the fee code
The maximum times you can bill for it (per each time bracket).

Emergency Department

***These are not eligible for Emergency Department Physicians, please see “Emergency Department by Emergency Department Physician” below.

Weekdays Mon. - Fri. "Sacrifice of Office hours" Evenings M-F Weekends & Holidays Nights
Travel Premium K960 : $36.40 Max. 2 K961 : $36.40 Max. 2 K962 : $36.40 Max. 2 K963 : $36.40 Max. 6 K964 : $36.40 Unlimited
First Person Seen K990 : $20.00 Max. 1 K992 : $40.00 Max. 1 K994 : $60.00 Max. 1 K998 : $75.00 Max. 1 K996 : $100.00 Unlimited
Additonal Person(s) Seen K991: $20.00 Max. 9 K993: $40.00 Max. 9 K995: $60.00 Max. 9 K999: $75.00 Max. 19 K997: $100.00 Unlimited


Hospital Out-Patient Department

Weekdays Mon. - Fri. "Sacrifice of Office hours" Evenings - Mon. - Fri. Weekends & Holidays Nights
Travel Premium U960 : $36.40 Max. 2 U961 : $36.40 Max. 2 U962 : $36.40 Max. 2 U963 : $36.40 Max. 6 U964 : $36.40 Unlimited
First Person Seen U990 : $20.00 Max. 1 U992 : $40.00 Max. 1 U994 : $60.00 Max. 1 U998 : $75.00 Max. 1 U996 : $100.00 Unlimited
Additonal Person(s) Seen U991: $20.00 Max. 9 U993: $40.00 Max. 9 U995: $60.00 Max. 9 U999: $75.00 Max. 19 U997: $100.00 Unlimited


Hospital In-Patient

Weekdays Mon. - Fri. "Sacrifice of Office hours" Evenings Mon. - Fri. Weekends & Holidays Nights
Travel Premium C960 : $36.40 Max. 2 C961 : $36.40 Max. 2 C962 : $36.40 Max. 2 C963 : $36.40 Max. 6 C964 : $36.40 Unlimited
First Person Seen C990 : $20.00 Max. 1 C992 : $40.00 Max. 1 C994 : $60.00 Max. 1 C986 : $75.00 Max. 1 C996 : $100.00 Unlimited
Additonal Person(s) Seen C991: $20.00 Max. 9 C993: $40.00 Max. 9 C995: $60.00 Max. 9 C987: $75.00 Max. 19 U997: $100.00 Unlimited


Long Term Care Institution

Weekdays Mon. - Fri. "Sacrifice of Office hours" Evenings Mon. - Fri. Weekends & Holidays Nights
Travel Premium W960 : $36.40 Max. 2 W961 : $36.40 Max. 2 W962 : $36.40 Max. 2 W963 : $36.40 Max. 6 W964 : $36.40 Unlimited
First Person Seen W990 : $20.00 Max. 1 W992 : $40.00 Max. 1 W994 : $60.00 Max. 1 W998 : $75.00 Max. 1 W996 : $100.00 Unlimited
Additonal Person(s) Seen W991: $20.00 Max. 9 W993: $40.00 Max. 9 W995: $60.00 Max. 9 W999: $75.00 Max. 19 W997: $100.00 Unlimited


Emergency Department by Emergency Department Physician

Weekdays Evenings Mon. - Fri. Weekends & Holidays Nights
Travel Premium H960 : $36.40 Max.. 2 H962 : $36.40 Max.. 2 H963 : $36.40 Max.. 4 H964 : $36.40 Unlimited
First Person Seen H980 : $20.00 Max.1H984 : $60.00 Max.1H988 : $75.00 Max.1 H986 : $100.00 Unlimited
Additional Person(s) Seen H981 : $20.00 Max.4 H985 : $60.00 Max.4H989 : $75.00 Max.9H987 : $100.00 Unlimited


Special Visit to a Patient's Home

(Excluding Long-Term Care Institutions).
Note: elective stands for home visits.

Weekdays - Both Elective & non-elective Mon.-Fri. "Sacrifice of Office hours" non-elective Evenings Mon.-Fri. non-elective Weekends & Holidays - non-elective Nights - non-elective
Travel Premium B960 : $36.40 Max. 2 B961 : $36.40 Max. 2 B962 : $36.40 Max. 2 B963 : $36.40 Max. 6 B964 : $36.40 Unlimited
First Person Seen B990 : $27.50 Max. 10 B992 : $44.00 Max. 10 B994 : $66.00 Max. 10 B993 : $$82.50 Max. 20 B996 : $110.00 Unlimited


Palliative Care Home Visit

Weekdays Mon.-Fri. "Sacrifice of Office hours" Evenings Mon.-Fri. Weekends & Holidays Nights
Travel Premium B966 : $36.40 Unlimited B966 : $36.40 Unlimited B966 : $36.40 Unlimited B966 : $36.40 Unlimited B966 : $36.40 Unlimited
First Person Seen B998 : $82.50 Unlimited B998 : $82.50 Unlimited B998 : $82.50 Unlimited B998 : $82.50 Unlimited B997 : $110.00 Unlimited


Physician Office

Weekdays Evenings Mon. - Fri. Weekends & Holidays Nights
Travel Premium A960 : $36.40 Max.. 1 A962 : $36.40 Max.. 1 A963 : $36.40 Max.. 1 A964 : $36.40 Unlimited
First Person Seen A990 : $20.00 Max.1A994 : $60.00 Max.1A998 : $75.00 Max.1 A996 : $100.00 Unlimited


Other (non-professional setting not listed)

Weekdays Mon.-Fri. "Sacrifice of Office hours" Evenings Mon.-Fri. Weekends & Holidays Nights
Travel Premium Q960 : $36.40 Max. 1 Q961 : $36.40 Max. 1 Q962 : $36.40 Max. 1 Q963 : $36.40 Max. 1 Q964 : $36.40 Unlimited
First Person Seen Q990 : $20.00 Max. 1 Q992 : $40.00 Max. 1 Q994 : $60.00 Max. 1 Q998 : $75.00 Max. 1 Q996 : $100.00 Max. 1


Geriatric Home Visit

Weekdays Mon.-Fri. "Sacrifice of Office hours" Evenings Mon.-Fri. Weekends & Holidays Nights
Travel Premium B986 : $36.40 Unlimited B986 : $36.40 Unlimited B986 : $36.40 Unlimited B986 : $36.40 Unlimited B986 : $36.40 Unlimited
First Person Seen B988 : $82.50 Unlimited B988 : $82.50 Unlimited B988 : $82.50 Unlimited B988 : $82.50 Unlimited B987 : $110.00 Unlimited

Obstetrical Delivery with Sacrifice of Office Hours

Weekdays "Sacrifice of Office hours" Evenings Mon.-Fri. Weekends & Holidays Nights
First Person Seen $0.00 C989 : $76.40 Unlimited $0.00 $0.00 $0.00


Billing Tips:

When billing OHIP premiums, make sure to include:

  • Time

  • Department

  • Requested by (Physician or Nurse)

  • Travel – you can bill up to 2 travel premiums per day and 6 on weekends/holidays, but it must be documented that you left the facility grounds and had to return in order to receive payment for 2nd travel premium.

  • First patient seen

  •  Be sure to use premiums that MATCH the SLI (service location indicator) on the claim.  


    Note: If a patient is being seen in the Emergency Department but is being admitted use the SLI - HIP but use  Emergency Department special visit premiums AND enter the admission date. This indicates to OHIP that the patient was seen in ER and then admitted.  This is especially important if you are billing E082 (admission assessment by MRP).


Want to maximize your earnings? New to Ontario Billing?

Check out our Ultimate OHIP Billing Guide that takes you through every step for billing successfully in Ontario.