Error code
H1 — Admission or Emergency Department assessment already paid
Admission assessment already paid
An admission or emergency department assessment was already paid for this patient, so this one was reduced or not paid.
What to do: Check which assessment was paid and by whom, against the rules on Schedule pages GP40 to GP42.
- Code
- H1
- Description
- Admission or Emergency Department assessment already paid
Explanation
Updated October 26, 2026
H1: an admission or emergency department assessment was already paid for this patient, so this one was reduced or not paid.
What it means
H1 means an admission assessment or emergency department assessment had already been paid for this patient, so OHIP did not pay this one in full.
Only one consultation, general or specific assessment or re-assessment is payable per admission when an in-patient is transferred from one physician to another; extra ones are adjusted to a lesser fee, and no extra admission assessment is payable for a transfer within the same hospital. An ED assessment can itself count as the admission assessment (Schedule GP40-GP42).
Common causes
- You assessed the patient in the ED and then billed a separate admission assessment, when the ED assessment counts as the admission assessment
- The patient was transferred to you within the same hospital
- Another physician already billed the admission assessment
How to fix it
- Check which assessment was paid and by whom.
- Compare your services with the rules on Schedule pages GP40 to GP42.
- If you believe your assessment should have been paid separately, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.
Don't resubmit if
- The claim is already on your RA. Use an RAI, not a new claim, if you disagree.
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