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Billing code

C991A — Weekday daytime in-patient special visit premium, additional patients

Daytime call premium, extra patients

Add for each additional in-patient seen on a non-elective weekday call, 07:00 to 17:00, when the trip earns a travel premium.

Watch for: A physician already on the hospital campus can't claim it on a weekday daytime, since no travel premium is payable.

Code

C991A

Description

Weekday daytime in-patient special visit premium, additional patients

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

Special visit premium for each additional hospital in-patient seen on a non-elective call, weekdays 07:00 to 17:00, when the trip earns a travel premium.

What it covers

C991 is the 'additional person(s) seen' premium in Special Visit Premium Table III, Hospital In-Patient, for weekday daytime (07:00 to 17:00) (GP72). It is billed for each further in-patient seen at the destination after the first (C990), provided each additional service starts during the eligible times (GP66).

A special visit is one initiated by the patient, or someone on their behalf, for a non-elective service (GP65). On weekday daytimes the patient-seen premiums are eligible only when a travel premium is payable for the trip, so C991 applies when the physician travels in to the hospital for the call (GP66).

Billing rules

• Weekday daytime premiums need a payable travel premium (C960). There is no travel premium for moving between buildings on the same hospital campus, so a physician already there can't claim C990 or C991 on a weekday daytime (GP66, GP72).
• Maximum 10 patients per time period for C990 and C991 combined (GP72).
• Not payable for patients seen on rounds, with the admission assessment of an elective admission, for non-referred or transferred obstetrical patients, or for a visit that pays critical care team fees (GP65).
• Bill the A-prefix assessment or consultation from the General Listings with the premium, not the C-prefix in-patient listing (GP12, GP69).
• The time of the visit must be in the medical record; in a hospital it can be anywhere in the common medical record (GP69).
• Not payable to a supervising physician for a medical trainee's service unless the supervising physician personally meets the special visit requirements (GP81).

Often billed with

• C990 first person seen and C960 travel premium (maximum 2 per time period) for the same weekday daytime call (GP72).
• A933 on-call admission assessment when a family physician on the hospital's on-call roster admits the patient non-electively and becomes the MRP (A7, GP65).
• E082 (+30%) on that admission assessment when the admitting physician is the MRP, once per admission (GP42).

Common rejections

• VH9: The health number on the claim isn't registered with the Ministry; check it against the patient's card or hospital record and resubmit.
• V18: OHIP's description is 'invalid admission/first visit date'. Check that the admission date on the claim is the date of this hospital admission.

Related codes: C990, C960, C993, C995, C987, C997, A933, U991

Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums, pages GP65 to GP69 and Table III on GP72

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