< Billing codes

Billing code

B998A — Palliative home special visit premium, first patient (not nights)

Palliative home visit first-patient premium

Bill B998 for the first patient seen on a palliative care home visit, 07:00 to 24:00 any day, with no maximum.

Watch for: On weekday daytimes without sacrificed office hours, it's only payable with the B966 travel premium.

Code

B998A

Description

Palliative home special visit premium, first patient (not nights)

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

First person seen premium for a palliative care home visit, 07:00 to 24:00 any day, with no maximum. Nights are B997.

What it covers

B998 is the first person seen premium in Special Visit Premium Table VII, Palliative Care Home Visit. One code covers weekday daytime (with or without sacrifice of office hours), weekday evenings and Saturdays, Sundays and holidays from 07:00 to 24:00; nights (00:00 to 07:00) are B997 (GP76).

Palliative care means care for a terminally ill patient in the final year of life, where no aggressive treatment of the underlying disease will be given and care is aimed at comfort (GP5).

Billing rules

• No maximum per time period (GP76).
• On weekday daytimes without sacrifice of office hours, a first person seen premium is only payable when a travel premium is payable for the trip, so bill B966 with it (GP66, GP76).
• Bill with the service for the visit: K023 palliative care support for 20 minutes or more, or A900 complex house call assessment for a shorter visit (OMA palliative care guide p.6; A2, A6).
• The time of the visit must be in the medical record (GP69).
• Still payable in a week when G512 palliative case management is billed (J102).
• FHO: not listed in Schedule 2 (core services), so not part of the base rate basket (Agreement pp.75-82; OMA palliative care guide p.12). B998A counts toward the palliative care special payment for enrolled and non-enrolled patients (Agreement p.66 §8.6).

Often billed with

• B966 travel premium (GP76).
• K023 palliative care support, per unit, with start and stop times recorded (A2).
• A902 pronouncement of death in the home, which includes the death certificate (A6).

Related codes: B966, B997, K023, A900, A902, G512, B990

Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums, pages GP65 to GP69 and Table VII on GP76; palliative care definition GP5; OMA palliative care guide (2023) pp.6 and 12

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing