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Billing code

E413A — After-hours procedure premium – ED physician – nights

ED night procedure premium

Adds 40% to an eligible procedure started between 00:00 and 07:00 by an emergency department physician billing H-prefix codes.

Watch for: Must be billed with the eligible procedure it increases; evenings and weekend daytime use E412 instead.

Code

E413A

Description

After-hours procedure premium – ED physician – nights

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

Adds 40% to an eligible procedure fee when an ED physician billing H-prefix codes starts the procedure between 00:00 and 07:00.

What it covers

E413 increases the procedural fee by 40% for an eligible procedure done by an Emergency Department Physician at night (00:00 to 07:00) (GP104).

Eligible services are non-elective surgical procedures (including fractures and dislocations), obstetrical deliveries, clinical procedures with diagnostic radiology, K101, K111, K102, K112, and the listed major invasive procedures such as G060, G268, G269 and J001 to J068 (GP104).

Billing rules

• Only for a procedure by an ED physician who, at that time, must submit claims using H-prefix ED codes (GP104).
• The procedure must be non-elective, or elective but delayed into the night by an intervening surgical emergency (GP104).
• ED physicians can't bill E409 or E410; those are for other physicians (GP104).
• For evenings (17:00–24:00 Mon–Fri) and weekend/holiday daytime and evenings, use E412 (+20%) instead (GP104).
• Add-on only: bill it with the eligible procedure (GP104).

Often billed with

• Non-elective procedures such as laceration repair, fracture or dislocation reduction (GP104).
• Major invasive procedures such as G060 nerve block, G268 arterial line or G269 central line (GP104).

Common rejections

• AD9: Premium not allowed alone: E413 must be billed with the eligible procedure it increases (GP104).

Related codes: E412, E409, E410, H112, G060, G269

Source: Schedule of Benefits (July 1, 2026), General Preamble, Other Premiums (After Hours Procedure Premiums), pages GP103–GP104.

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