Click here for a general guideline to All OHIP Special Visit Premiums.
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SPECIAL VISIT PREMIUMS
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.
Always use the “A” prefix general listing visit codes. The “C” prefix consult codes are strictly for non-emergency inpatient consults (and therefore no special visits apply).
Applies only to the First Person Seen.
This is used when travel is required to the facility to see a patient and is always billed with the “First Person Seen”. Any additional patients seen on the same visit are billed with the “Additional person(s) seen” premium instead.
There is a special visit premium table for different visit locations.
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)
Special visit premiums do not apply to subsequent hospital inpatient visits.
Visit fees and related premiums must be kept together on the SAME bill.
Want to know how to maximize your Ontario Billing? Check out our OHIP Billing Guide.