Remittance Advice · Payment-time (remittance)
OHIP explanatory code M4
Maximum fee allowed for these services by one or more practitioners has been reached
What M4 means
The Ministry of Health’s official wording for M4 is: “Maximum fee allowed for these services by one or more practitioners has been reached.”
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 M4
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
- LSPaid in accordance to special Lab Agreement
- M1Maximum fee allowed or maximum number of service has been reached same/any provider
- M2Maximum allowance for radiographic examination(s) by one or more practitioners
- M3Maximum fee allowed for prenatal care
- M5Monthly maximum has been reached
- M6Maximum fee allowed for special visit premium-additional patient seen
- MAMaximum number of sessions has been reached
- MCMaximum number of case conferences has been reached in a 12 month period
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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.