OHIP Remittance Advice code P5
Over-age for paediatric rates of payment
Ontario Ministry of Health, Remittance Advice Explanatory Codes
Where you’ll see it
On your Remittance Advice. The claim was assessed, and this explanatory code says how it was paid, reduced or refused. The Remittance Advice arrives monthly, in the first week.
The fee code doesn't fit this claim
The service code billed doesn't fit the claim as submitted: wrong for the date, the patient, or the other codes on the same claim. Check the Schedule of Benefits rule for the code, choose the one that matches what was done, and resubmit.
For a claim already on your Remittance Advice, follow the ministry's instruction in the description. That is either a corrected resubmission or a Remittance Advice Inquiry (RAI), and both are still subject to the three-month limit from the date of service.
Our summary is a guide, not a ruling. The ministry’s wording and the current Schedule of Benefits are what OHIP applies. See OHIP Error Report vs Remittance Advice: reading the codes for how the two reports differ.
Related Remittance Advice codes
- O5 · Not allowed in addition to delivery
- O7 · Allowed as subsequent prenatal visit-initial prenatal visit already claimed
- O9 · Not allowed in addition to post-natal care
- P4 · Fee for newborn care/low birth weight care is not billable with neonatal intensive care
- P6 · Over-age for well-baby care
- P9 · Complex New patient
- S5 · Not allowed in addition to major surgical fee
- S6 · Allowed as subsequent procedure-initial procedure previously claimed