What are the billing rules for C997A?

Each additional patient's service must start between 00:00 and 07:00 (GP66). No maximum number of patients per time period (GP72). Patients seen on rounds don't qualify, even after a non-elective call (GP65, GP66).

What is C997A often billed with?

C996 first person seen on the same night call (GP72). A933 on-call admission assessment for a non-elective admission, with E082 when the admitting physician is the MRP (A7, GP42). A003 general assessment as the A-prefix assessment for a patient seen on the call (A4, GP69).

Why is C997A rejected?

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. V66: OHIP's description is 'missing admission date'. Add the admission date of the patient's current hospital stay to the claim and resubmit.

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Billing code

C997A — Night in-patient special visit premium, additional patients

Q: What is OHIP billing code C997A?

Special visit premium for each additional hospital in-patient seen on a non-elective call at night, 00:00 to 07:00. No maximum per period.

Night call premium, extra patients

Add for each additional in-patient seen on a non-elective call between 00:00 and 07:00; there's no maximum per period.

Watch for: Patients seen on rounds don't qualify; include the patient's admission date on the claim.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$102.80	$0.00	$0.00	$0.00	$0.00

Code: C997A
Description: Night 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 at night, 00:00 to 07:00. No maximum per period.

What it covers

C997 is the 'additional person(s) seen' premium in Special Visit Premium Table III, Hospital In-Patient, for nights 00:00 to 07:00 (GP72).

It is billed for each in-patient seen at the destination after the first person (C996), when each additional service starts during the night period (GP66). A special visit is one initiated by the patient, or someone on their behalf, for a non-elective service (GP65).

Billing rules

Each additional patient's service must start between 00:00 and 07:00 (GP66).
No maximum number of patients per time period (GP72).
Patients seen on rounds don't qualify, even after a non-elective call (GP65, GP66).
Not payable with the admission assessment of an elective admission, or for non-referred or transferred obstetrical patients (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).

Often billed with

C996 first person seen on the same night call (GP72).
A933 on-call admission assessment for a non-elective admission, with E082 when the admitting physician is the MRP (A7, GP42).
A003 general assessment as the A-prefix assessment for a patient seen on the call (A4, GP69).

Common rejections

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.
V66: OHIP's description is 'missing admission date'. Add the admission date of the patient's current hospital stay to the claim and resubmit.

Related codes: C996, C964, C995, C987, U997, A933

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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