Error code
DA — Procedure maximum reached - paid as repeat/chronic procedure
Repeat or chronic fee paid
The maximum for the initial procedure was reached, so OHIP paid it at the repeat or chronic fee.
What to do: Count the initial or acute services billed for this patient; send an inquiry only if fewer than the maximum were paid.
- Code
- DA
- Description
- Procedure maximum reached - paid as repeat/chronic procedure
Explanation
Updated October 26, 2026
OHIP paid this procedure at the repeat or chronic fee because the maximum for the initial procedure was reached.
What it means
Code DA means the maximum for this procedure was reached, so it was paid at the repeat or chronic procedure fee.
Some procedures pay an initial or acute rate for a set number of services, then a lower repeat or chronic rate. For example, several dialysis codes are listed as 'initial and acute (for the first 3 services)', with separate chronic codes after that, such as G090 and G096 for slow continuous ultrafiltration (J37).
Common causes
- The initial or acute number of services was already used
How to fix it
- Count how many of the initial or acute services were billed for this patient.
- If fewer than the maximum were paid, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with supporting details such as your chart notes.
- Otherwise, the repeat or chronic payment is correct.
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