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Billing code

U993A — Weekday out-patient special visit premium, office hours sacrificed, additional patients

Office hours sacrificed, more patients

Bill for each additional out-patient seen after the first (U992) on a weekday daytime call that sacrificed booked office hours.

Watch for: Booked office visits must have been delayed or cancelled; maximum 10 patients per time period for U992 and U993 combined.

Code

U993A

Description

Weekday out-patient special visit premium, office hours sacrificed, 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 out-patient seen on a non-elective weekday daytime hospital call that sacrifices booked office hours.

What it covers

U993 is the 'additional person(s) seen' premium in Special Visit Premium Table II, Hospital Out-Patient Department, for weekday daytime (07:00 to 17:00) with sacrifice of office hours (GP71). It is billed for each patient seen at the destination after the first (U992), when each service starts during the eligible times (GP66).

Sacrifice of office hours means the physician makes a previously unscheduled non-elective visit at a time when office patients were booked, and at least one of those office visits was delayed or cancelled because of it (GP65).

Billing rules

• Only on a call that sacrificed office hours: booked office visits were delayed or cancelled because of the unscheduled non-elective visit (GP65).
• Maximum 10 patients per time period for U992 and U993 combined (GP71).
• Not payable for non-referred or transferred obstetrical patients, for a visit that pays critical care team fees, or with emergency department H-prefix codes (GP65).
• Bill the A-prefix assessment or consultation from the General Listings with the premium (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

• U992 first person seen on the same call (GP71).
• U961 travel premium when the physician travels to the hospital, maximum 2 per time period (GP71).
• A003 general assessment, or another A-prefix assessment, for each patient (A4, GP69).

Related codes: U992, U961, U991, U995, C993, K992

Source: Schedule of Benefits (July 1, 2026), General Preamble, Special Visit Premiums, pages GP65 to GP69 and Table II on GP71

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