How do I fix OHIP error code B5?

Compare the in-person line with the paid virtual claim: date, physician and problem. If the virtual visit led to the in-person one, the in-person service is the payable one. Send an RAI asking for the virtual claim to be reversed and this one paid, with chart notes. If they were separate, medically necessary visits, send an RAI with the chart notes for both. Send RAIs through eSubmit, or on form 0918-84, within 7 months of the RA date.

When shouldn't I resubmit a B5 claim?

The claim is already on the RA and you only disagree with the decision. Use an RAI, not a new claim.

< Error codes

Error code

B5 — In-person service not allowed with the same virtual service

Q: What does OHIP error code B5 mean?

OHIP didn't pay this in-person service because the same service was already paid as a virtual service for this patient. Compare both claims.

Already paid as virtual

The same service was already paid as a virtual service for this patient, so the in-person line wasn't paid.

What to do: If the virtual visit led to the in-person one, ask by inquiry for the virtual claim reversed and this one paid.

Code: B5
Description: In-person service not allowed with the same virtual service

Explanation

Updated October 26, 2026

OHIP didn't pay this in-person service because the same service was already paid as a virtual service for this patient. Compare both claims.

What it means

Code B5 means an in-person service was refused because the virtual version of the same service was already paid for the patient. The in-person line is the one not paid.

The Ministry's code list doesn't say over what period the two are compared. Under the Schedule, if a virtual visit shows that an in-person encounter is needed, only the in-person service is payable, not both (A67).

Common causes

A virtual visit and an in-person visit for the same problem both billed
The same encounter billed both as virtual and in person
The in-person visit was billed with a virtual modality indicator, or the virtual claim had the wrong date

How to fix it

Compare the in-person line with the paid virtual claim: date, physician and problem.
If the virtual visit led to the in-person one, the in-person service is the payable one. Send an RAI asking for the virtual claim to be reversed and this one paid, with chart notes.
If they were separate, medically necessary visits, send an RAI with the chart notes for both.
Send RAIs through eSubmit, or on form 0918-84, within 7 months of the RA date.

Don't resubmit if

The claim is already on the RA and you only disagree with the decision. Use an RAI, not a new claim.

How APEX handles it

APEX reads your error reports and remittance advice from MCEDT and lists claims rejected with this code in its Correction Centre for you to correct and resubmit. See how APEX works · Pricing

Related codes: B4, B6, B7, TM5