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Billing code

B994A — Weekday evening home special visit premium, first patient

Weekday evening home first-patient premium

Bill B994 for the first patient seen on a non-elective home visit Monday to Friday, 17:00 to 24:00.

Watch for: Only paid with an eligible A-prefix assessment on the same claim; elective evening visits use B960 and B990.

Code

B994A

Description

Weekday evening home special visit premium, first patient

FHO+ basket

Covered by the FHO+ base rate payment for enrolled patients, and shadow billed at 30% (50% for Schedule 2B procedures).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Home special visit premium for the first patient seen on a non-elective call, Monday to Friday evenings (17:00 to 24:00).

What it covers

B994 is the first person seen premium in Special Visit Premium Table VI, Patient's Home (other than long-term care), for non-elective visits Monday to Friday, 17:00 to 24:00 (GP75).

A first person seen premium applies when the service starts on a weekday evening (GP66). Elective evening home visits are billed with B960 and B990 instead (GP65, GP75).

Billing rules

• Maximum 10 per time period (GP75).
• Only for the first patient seen, however many patients are seen in one home or in units of one multiple resident dwelling (GP75).
• A special visit is one initiated by the patient, or someone on their behalf, for a non-elective service (GP65).
• Not payable with A001 or A007 done in the home, because travel is part of those services (GP75, A4).
• Bill an eligible A-prefix assessment with the premium, such as A900 (GP69, A6).
• The time of the visit must be in the medical record (GP69).
• FHO: B994A is a Schedule 2 core service, in basket, and counts toward the home visit bonus (Agreement p.67 §8.9, p.76).

Often billed with

• B962 travel premium, weekday evening, maximum 2 per time period (GP75).
• A900 complex house call assessment for a frail elderly or housebound patient (A6).

Common rejections

• ADF: OHIP's description is 'required related procedure missing, invalid or paid at zero'. B994 is only paid with an eligible A-prefix assessment on the same claim (GP69); A001 and A007 don't qualify in the home (A4).

Related codes: B962, B990, B993, B996, B992, A900

Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums, pages GP65 to GP69 and Table VI on GP75

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