Remittance Advice · Payment-time (remittance)
OHIP explanatory code H5
Maximum fee allowed per month after the 13th week
What H5 means
The Ministry of Health’s official wording for H5 is: “Maximum fee allowed per month after the 13th week.”
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 H5
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
- H1Admission assessment or Emergency department assessment already paid
- H2Allowed as subsequent visit - initial visit previously claimed
- H3Maximum fee allowed per week after 5th week
- H4Maximum fee allowed per week after 6th week to pediatricians
- H6Allowed as supportive or concurrent care
- H7Allowed as chronic care
- H8Hospital number and/or admission date required for in-hospital service
- H9Concurrent care already claimed by another doctor
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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.