Remittance Advice · Payment-time (remittance)
OHIP explanatory code D4
Procedure allowed at 50% with visit
What D4 means
The Ministry of Health’s official wording for D4 is: “Procedure allowed at 50% with visit.”
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 D4
The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
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
- C9Allowed as in-patient interim admission orders-initial assessment already claimed by other physician
- D1Allowed as repeat procedure-initial procedure previously claimed
- D2Additional procedures allowed at 50%
- D3Not allowed in addition to visit fee
- D5Procedure already allowed-visit fee adjusted
- D6Limit of payment for this procedure reached
- D7Not allowed in addition to other procedure
- D8Allowed with specific procedures only
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Code meaning per Ontario Ministry of Health — Remittance Advice Explanatory Codes / Messages (March 2026). The suggested action is general information for Ontario physicians, not billing, legal, or tax advice — codes and rules change, so verify against the current Ministry of Health documents before relying on a claim.