< Error codes

Error code

MD — Daily maximum has been exceeded

Over the daily maximum

The services or units billed went over a daily maximum in the Schedule, so those over the limit weren't paid.

What to do: Find the code's daily limit, check whether it counts per patient, physician or both, and count every service that day.

Code
MD
Description
Daily maximum has been exceeded

Explanation

Updated October 26, 2026

MD means the claim went over a daily maximum in the Schedule of Benefits, so services over the limit weren't paid. Check the code's per-day limit.

What it means

MD is a remittance advice explanatory code, not an Error Report rejection. The Ministry's wording is 'Daily maximum has been exceeded'. OHIP processed the claim but didn't pay for the services or units over the limit for that day.

Many fee codes cap how many services or units are payable in a day: per patient, per physician, or both. The General Preamble adds that when the Schedule gives a maximum without a time period, it means per patient per day, and services over it that day are not eligible for payment (GP7).

Family practice examples: chronic disease shared appointments (K140 to K144) up to 8 units per patient per day (A22); case conferences such as K121 and K700 up to 8 units per physician per patient per day (A33); K028 STI management up to 2 units per patient per physician per day (A52); insect venom desensitisation G205 up to 5 injections per day (J4); and no more than 8 nerve blocks of any kind per patient per day (J70).

Common causes

  • More units billed for a time-based service than the daily cap allows
  • The same per-day service billed twice for the patient on one date, on two claims or by two physicians where the limit counts every physician
  • The number of services keyed wrong, for example 2 instead of 1
  • One long session split across two claims for the same day

How to fix it

  1. Find the code's daily limit in the Schedule of Benefits and check who it counts: the patient, the physician, or both.
  2. Count every service or unit billed for that patient on that date, on all your claims and, where the limit counts any physician, other physicians' claims too.
  3. If more was billed than the limit allows, there is nothing to correct. Services over a daily maximum aren't payable.
  4. If the number of services was keyed wrong, or you believe OHIP counted wrongly, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date. For time-based services, include the charted start and stop times.

Don't resubmit if

  • The services billed really were over the daily limit.
  • You'd be moving the extra services to another date. The service date must be the day the service was given.
  • The claim is on the RA. Disputes about a paid or reduced claim go through an RAI, not a new claim.

How APEX handles it

APEX has no correction rule for MD and doesn't send inquiries for it. If nothing on the visit was paid, the claim is listed in the Correction Centre under Outstanding for you to review. If other services on the visit were paid, the line stays in your claims with the billed and paid amounts. See how APEX works · Pricing

Related codes: M1, MU, MY, M5

Sources