OHIP explanatory code B5

What B5 means

The Ministry of Health’s official wording for B5 is: “In-Person Service Not Allowed in Addition to Virtual Equivalent Service.”

This code appears as an explanatory code on your monthly Remittance Advice (RA). It means the claim was adjudicated — paid, reduced, or refused — for the reason below. A claim already on your RA generally shouldn't be blindly resubmitted; follow the suggested action.

How to fix B5

An in-person service isn't payable in addition to its virtual equivalent - check whether the virtual service was already claimed for that patient and date; if only the in-person service was actually rendered, file a Remittance Advice Inquiry.

Payment-time codes appear on the monthly Remittance Advice after adjudication. Some are informational, some explain a reduced or refused payment. Where you disagree with the outcome, the usual route is a Remittance Advice Inquiry or written inquiry — not resubmitting the same claim, which can create a duplicate.

Related codes

• B1Service Not Eligible for Payment When Delivered by Telephone
• B2Paid in accordance with the OHIP Schedule of Benefits for Telephone Virtual Care Services
• B3Patient-Physician Relationship Requirements Not Met
• B4Virtual Service not allowed in addition to In-Person Equivalent Service
• B6Limited Virtual Care Service Already Paid
• B7Comprehensive Virtual Care Service Already Paid
• B8Service Not Eligible for Payment Virtually
• C1Allowed as repeat/limited consultation/midwife-requested emergency assessment