What are the billing rules for E409A?

Only for non-elective surgical procedures (including fractures and dislocations), obstetrical deliveries, clinical procedures with diagnostic radiological exams, K101, K111, K102, K112 or the listed major invasive procedures (GP103-GP104). The procedure must be non-elective, or an elective procedure delayed into the after-hours period by an intervening emergency surgical procedure (GP104). Not payable for a procedure by an emergency department physician; they bill E412 when billing H-prefix emergency services (GP104).

What is E409A often billed with?

Obstetrical delivery codes such as P006 (vaginal delivery) and P009 (attendance at labour and delivery), since obstetrical deliveries are eligible (GP104, K6-K7). E411 sole delivery premium when it is the only delivery that calendar day (K7).

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Billing code

E409A — After-hours procedure premium, evening/weekend/holiday

Q: What is OHIP billing code E409A?

+50% after-hours premium on the procedural fee for eligible procedures started weekday evenings or Saturday, Sunday or holiday daytime and evenings.

Evening and weekend procedure premium

Adds 50% to the procedural fee for an eligible non-elective procedure started weekday evenings or weekend or holiday daytime and evenings.

Watch for: Not for elective procedures unless delayed by an emergency; emergency department physicians bill E412 instead.

Provider	Specialist	Assistant	Anaesthetist	Non-anaesthetist
$0.01	$0.00	$0.00	$0.00	$0.00

Code: E409A
Description: After-hours procedure premium, evening/weekend/holiday
FHO+ basket: Not in the FHO+ base rate basket (Schedule 2 or 2B).
Effective date: Apr 3, 2020
Termination date: No end date

Explanation

Updated October 26, 2026

+50% after-hours premium on the procedural fee for eligible procedures started weekday evenings or Saturday, Sunday or holiday daytime and evenings.

What it covers

E409 increases the procedural fee by 50% for an eligible procedure started on a weekday evening (17:00 to 24:00) or during daytime or evening hours (07:00 to 24:00) on a Saturday, Sunday or holiday (GP104).

It is for physicians other than emergency department physicians; the emergency department physician's version is E412 (+20%) (GP104).

Billing rules

Only for non-elective surgical procedures (including fractures and dislocations), obstetrical deliveries, clinical procedures with diagnostic radiological exams, K101, K111, K102, K112 or the listed major invasive procedures (GP103-GP104).
The procedure must be non-elective, or an elective procedure delayed into the after-hours period by an intervening emergency surgical procedure (GP104).
Not payable for a procedure by an emergency department physician; they bill E412 when billing H-prefix emergency services (GP104).
For a special visit to do a non-elective surgical procedure after 17:00 or on a weekend or holiday, claim the consultation or assessment, the special visit premium, the procedural fee and E409 or E410 (SP2).
Surgical assistants and anaesthetists have their own after-hours premiums, E400B and E400C (GP87, GP94).
FHO: E409A is one of the codes an Income Stabilization physician may bill at full fee-for-service (Agreement p.99).

Often billed with

Obstetrical delivery codes such as P006 (vaginal delivery) and P009 (attendance at labour and delivery), since obstetrical deliveries are eligible (GP104, K6-K7).
E411 sole delivery premium when it is the only delivery that calendar day (K7).

Related codes: E410, E412, E413, E400, E401, P006, P009

Source: Schedule of Benefits (July 1, 2026), General Preamble, Other Premiums, After Hours Procedure Premiums, pages GP103-GP104; Surgical Preamble SP2; Obstetrics K3.

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