Billing code
B996A — Home special visit premium – first person seen – night
Night home first-patient premium
Bill B996 for the first patient seen on a non-elective home visit at night, between 00:00 and 07:00.
Watch for: Submit it on the same claim as the A-prefix assessment, and chart the time of the visit.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $113.10 | $0.00 | $0.00 | $0.00 | $0.00 |
- Code
- B996A
- Description
- Home special visit premium – first person seen – night
- 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
Premium for the first patient seen on a non-elective home visit at night, between midnight and 7:00.
What it covers
B996 is the Table VI special visit premium for the first person seen on a non-elective visit to a patient's home (not an LTC home) at night, 00:00 to 07:00 (GP75). The night travel premium is B964 (GP75).
Home means the patient's residence, including an apartment, retirement home, hotel, shelter, group home or similar, but not a hospital or LTC home (GP4).
Billing rules
- No maximum per time period for B996 or B964 (GP75).
- Only the first patient seen is paid, even if you see several people in one home or in several units of a multiple resident dwelling (GP75).
- Not payable with A001 or A007 done in the home (GP75).
- Bill an A-prefix assessment from the General Listings with the premium, and chart the time of the visit (GP69).
- Elective home visits use B960/B990 instead (GP65, GP75).
- FHO: B996 is a Schedule 2 core code (Agreement p.76) and counts toward the home visits special payment (Agreement p.67 §8.9).
Often billed with
- B964 home travel premium, nights (GP75).
- A900 complex house call assessment (A6).
- A902 pronouncement of death in the home (A6).
Common rejections
- AD9: 'Premium not allowed alone': submit B996 on the same claim as the A-prefix assessment it goes with (GP69).
Related codes: B964, B990, B992, B993, B994, B997, A900, A902
Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums, page GP75.
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