What is the extended clinic hours premium in Manitoba (5530 and 5531)?
In Manitoba, tariff 5530 adds 20% and tariff 5531 adds 30% to the payable fee for each eligible service that starts in extended clinic hours (Manitoba Physician's Manual, pages A-125 to A-126). 5530 covers weekday mornings from 6:00 a.m. to 8:00 a.m. and daytime on weekends and holidays, plus evenings from 5:00 p.m. Monday to Thursday excluding designated holidays. 5531 covers 5:00 p.m. to 11:59 p.m. on Friday, Saturday, Sunday and designated holidays. The clinic must meet the manual's regular-hours and advertising conditions, and the time the service started must be on the claim.
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
The fees
| Tariff | Description | Fee | Manual page | Manual dated |
|---|---|---|---|---|
| 5530 | Extended clinic hours: weekday early mornings, Monday to Thursday evenings excluding designated holidays, weekend and holiday daytime | 20% of the payable fee for each eligible service | A-125 | |
| 5531 | Extended clinic hours: evenings on Friday, Saturday, Sunday and designated holidays | 30% of the payable fee for each eligible service | A-126 |
When it applies / when it does not
The premium applies to medical services that start in the hours below. The manual's word is "commencing" (A-126). The manual gives the hours in 24-hour time.
| Tariff | Days | Service starts between | Manual page |
|---|---|---|---|
| 5530 | Monday to Friday | 0600 to 0800 (6:00 a.m. to 8:00 a.m.) | A-125 |
| 5530 | Monday to Thursday, excluding designated holidays | 1700 to 2359 (5:00 p.m. to 11:59 p.m.) | A-125 |
| 5530 | Saturday, Sunday and designated holidays | 0700 to 1659 (7:00 a.m. to 4:59 p.m.) | A-125 |
| 5531 | Friday, Saturday, Sunday and designated holidays | 1700 to 2359 (5:00 p.m. to 11:59 p.m.) | A-126 |
When it applies
- The clinic "(a) maintains at least 8 hours of regular office hours within 0800-1700 Monday [to] Friday (For example, 0800-1600, or 0830-1630, or 0900-1700); or (b) operates as an SDO approved Extended Primary Care (EPC) clinic". (A-126) The pages we checked do not spell out "SDO".
- And "the extended clinic hours are advertised to the public or the clinic's own patients and the patient has the option for in person availability." (A-126)
- "The time the service commences must be entered on the claim." (A-126)
- The manual lists these designated holidays: New Year's Day, Louis Riel Day, Good Friday, Easter Monday, Victoria Day, Canada Day, Terry Fox Day, Labour Day, National Day for Truth and Reconciliation, Thanksgiving Day, Remembrance Day, Christmas Day and Boxing Day (A-126). When one falls on a Saturday or Sunday, the day observed is the one Manitoba Health lists on its claims page for providers.
When it does not apply
- "An extended clinic hours premium may not be claimed for a patient scheduled to be seen before the extended hours period." (A-126)
- "5530 or 5531 may not be claimed with tariffs 5555, 5553, 5550, 5556, 5557 and 5558." (A-126) Tariffs 5555, 5553 and 5550 are the after-hours premiums. (B-1)
- Tariffs 8000, 8001, 8002, 8003 and 8005 are not eligible (telephone, fax and email communication tariffs, and anticoagulant monitoring by phone). Nor are "annual management tariffs such as but not limited to CDM and CCM tariffs". (A-126) The chronic disease management tariffs are 8431, 8432, 8433, 8434 and 8435. (A-124) The pages we checked do not spell out "CCM".
Worked example
A 40-year-old patient is booked for 6:15 p.m. on a Tuesday that is not a holiday. The clinic meets the regular-hours and advertising conditions. You see the patient at 6:15 p.m. for a 12-minute visit, billed as 8529 ($41.02, A-119).
Add 5530: 20% of $41.02 is $8.20. Enter 1815 as the time the service started. On a Friday at the same time, 5531 applies instead. 30% of $41.02 is $12.31. Both amounts are rounded to the cent. Had the patient been booked for 4:40 p.m. and seen at 5:10 p.m., no premium applies. The patient was scheduled before the extended hours period.
What is often not billed
The premium itself, when the start time is missing. The premium can be claimed only when the time the service started is on the claim (A-126). If neither the note nor the appointment schedule records that time, the claim cannot show it.
Source
Manitoba Physician's Manual, April 1, 2026 edition (with the October 1, 2026 update), pages A-119, A-124 to A-126 and B-1. Manitoba Health publishes the manual at gov.mb.ca/health/manual.
Last checked: Checked against the Manitoba Physician's Manual (April 1, 2026 edition, with the October 1, 2026 update) by Unbilled on . Not yet reviewed by a medical biller.
Unbilled is not Manitoba Health or Doctors Manitoba. This page is general information, not a ruling on any claim. Manitoba Health decides what is payable. Check the current manual before you bill.
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