Error code
H3 — Weekly maximum fee applies after the 5th week
Over weekly visit limit
After the 5th week in hospital, subsequent visits are limited per week; visits over the limit weren't paid.
What to do: Count the week's visits and check the admission date; bill acute intercurrent illness visits as C121.
- Code
- H3
- Description
- Weekly maximum fee applies after the 5th week
Explanation
Updated October 26, 2026
H3: after the 5th week in hospital, subsequent visits are limited per week. Visits over the limit weren't paid. Use C121 for acute intercurrent illness.
What it means
H3 means the patient had been in hospital more than 5 weeks, and OHIP paid only up to the weekly maximum for subsequent visits.
In-hospital subsequent visits are limited to one per patient per day for the first 5 weeks after admission (C002), 3 per week from week 6 to 13 (C007), and 6 per month after 13 weeks (C009). Visits over the limit are not payable. Visits for an acute intercurrent illness after week 5 are billed as C121 and don't count toward the limits (Schedule GP43, A13). When a patient is referred within hospital, the weeks are counted from the date the second physician first saw them.
Common causes
- More than 3 subsequent visits in a week between week 6 and week 13 of the stay
- Visits for an acute intercurrent illness billed as regular subsequent visits instead of C121
- The admission date on the claim makes the stay look longer than it was for you (for example, after an in-hospital referral)
How to fix it
- Count the subsequent visits billed for that week.
- Check the admission date. After a referral within the hospital, use the date you first saw the patient.
- If extra visits were for an acute intercurrent illness, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with notes; bill such visits as C121 in future.
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