After the holiday season, our doctors have one pressing question they want answered. Which days are considered “holidays” according to OHIP’s Schedule of Benefits? Many of you have worked hard over the past few weeks, so read on to find out which days are eligible for more lucrative special visit premiums.
According to GP3 in the Schedule of Benefits, the following are defined as ‘Holidays’:
|Christmas Day – Dec 25||if Christmas falls on Saturday, both the Friday before and Monday after are holidays; if it falls on a Sunday, the Monday is a holiday|
|Boxing Day – Dec 26||if Boxing day falls on a Saturday, the Monday following is a holiday|
|New Years Day – Jan 1||if New Years day falls on a Sat or Sun, the physician can choose either the Fri or the Mon to be the holiday|
|Canada Day – Jul 1||if Canada day falls on a Sat or Sun, the physician can choose either the Fri or the Mon to be the holiday|
Applying your Holiday Special Visit Premiums
What does this mean in practice? Well in 2014, Dec 25 fell on a Thursday. Thus a specialist called to see a patient on an urgent basis on the ward at 2:00pm could bill C987 ($75.00) instead of C991 ($20.00) with their assessment code.
On New Year’s Day, an internist called to the Emergency Department at 11:30pm could bill K998 ($75.00) with their travel premium K963 instead of the evening premium K994 ($60.00) with K962. In other words, holiday premiums are more lucrative than the usual daytime ($20.00) or evening ($60.00) special visit premiums, but not the night-time premiums ($100.00).
For more on how to bill these premiums, see our blog on Special Visit Premiums.