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Billing code

K998A — Sat., Sun And Holidays (07:00 - 24:00)

Weekend ED special visit

Bill K998 for the first patient you see on a special visit to the emergency department on a Saturday, Sunday or holiday, 07:00–24:00.

Watch for: Not payable to scheduled emergency department physicians, and must be billed with an A-prefix assessment, not H-prefix codes.

Code

K998A

Description

Sat., Sun And Holidays (07:00 - 24:00)

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

ED special visit premium for the first patient seen, Saturday, Sunday or holiday 07:00–24:00. Not payable to Emergency Department Physicians.

What it covers

K998 is the first-person-seen premium when a physician who is not on duty in the emergency department makes a special visit to the ED, on a Saturday, Sunday or holiday (07:00–24:00) (GP70, Table I). A special visit is one initiated by or for the patient for a non-elective service (GP65).

The travel premium for the same period is K963, and further patients seen on that visit use K999 (GP70).

Billing rules

• Not payable to Emergency Department Physicians (scheduled ED staff or scheduled ED on-call), who use Table V (H-prefix premiums) instead (GP67, GP70).
• Bill with the appropriate A-prefix assessment from the General Listings; not payable with ED H-prefix codes (GP65, GP69).
• Maximum: 20 first and additional persons seen combined per time period (GP70). Patients beyond the limit on that visit are billed with H-prefix codes (GP68).
• Not payable for patients seen on rounds, with critical care team fees, for elective admissions, or for walk-ins or patients seen just before, during or after regular office hours (GP65).
• Record the time of the special visit in the medical record (GP69).
• Procedures started on a weekend or holiday on the same visit can also take E409 (+50%) (SP2, GP104).

Often billed with

• K963 travel premium for the same time period (GP70).
• An A-prefix assessment from the General Listings (GP69).

Common rejections

• AD9: 'Premium not allowed alone': the premium was billed without an eligible service, such as the A-prefix assessment, on the claim (GP65, GP69).

Related codes: K963, K999, K994, K996, K992, E409

Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums (Table I – Emergency Department), page GP70; rules GP65–GP69.

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