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A new premium has been established that will add 15% to all eligible hospital visit tariffs. This new premium will support retention and recruitment of hospital-based physicians. 

The new premium applies to all visit tariffs associated with patients in emergency departments and admitted to hospital but excludes outpatient clinics.

Examples include daily care (8520), concomitant care (8524), consultations, complete history and regional visits. General schedule services such as conferences or communications are not eligible for this additional benefit. 

UPDATE — For visits on or after February 15, 2024: this premium will be automatically applied to the tariffs listed below if provided in an eligible hospital setting. Visits provided ahead of this date will require add-on tariff 5515 be claimed in order to capture the Hospital Care Premium. If you bill tariff 5515 after this date, you will receive rejection code 6H — hospital premium applied.

The following eligible tariffs will have the 15% automatically applied for visits on or after February 15, 2024 when rendered for services provided in a hospital in-patient setting or an Emergency Department: 8300, 8301, 8302, 8303, 8304, 8305, 8306, 8307, 8308, 8409, 8410, 8411, 8412, 8413, 8444,8446, 8452, 8466, 8467, 8468, 8477, 8490, 8495, 8502, 8503, 8504, 8508, 8510, 8512, 8520, 8524, 8526, 8536, 8540, 8543, 8544, 8550, 8551, 8553, 8554, 8556, 8557, 8581, 8584, 8594, 8595, 8596, 8599, 8614, 8615, 8617, 8620, 8622, 8623, 8624, 8625, 8626, 8635, 8645, 8646, 8647, 8660, 8662, 8663, 8664, 8667, 8704, 8706, 8707, 8708, 8732 and 8733.

8529 and 8509 for urgent/​emergent services provided in the Emergency Department are also eligible. Note: emergency indicator required for automatic application of the premium.

For visits before February 15, 2024: You must continue to claim the hospital premium tariff for any eligible visits between October 1, 2023 and February 14, 2024. The rate table for this new tariff is below:

5515
Hospital Care Premium 15% on payable fee

Hospital Care Premium, add on to visit fee

Notes: May only be claimed in addition to tariffs 8300, 8301, 8302, 8303, 8304, 8305, 8306, 8307, 8308, 8409, 8410, 8411, 8412, 8413, 8444, 8446, 8452, 8466, 8467, 8468, 8477, 8490, 8495, 8502, 8503, 8504, 8508, 8510, 8512, 8520, 8524, 8526, 8536, 8540, 8543, 8544, 8550, 8551, 8553, 8554, 8556, 8557, 8581, 8584, 8594, 8595, 8596, 8599, 8614, 8615, 8617, 8620, 8622, 8623, 8624, 8625, 8626, 8645, 8646, 8647, 8660, 8662, 8663, 8664, 8667, 8704, 8706, 8707, 8708, 8732 and 8733 when rendered for in-patient service in a hospital.

Last updated
February 9, 2024