Error code
R3 — Only 1 well-child exam (age 2-5) allowed within 12 months
Well-child exam already paid
Only one well-child exam for ages 2 to 5 is allowed in 12 months, and one was already paid.
What to do: Find the date of the last paid well-child exam; if under 12 months earlier, this one isn't payable.
- Code
- R3
- Description
- Only 1 well-child exam (age 2-5) allowed within 12 months
Explanation
Updated October 26, 2026
R3 means only one well-child exam (age 2 to 5) is allowed in a 12-month period, and one was already paid.
What it means
Code R3 means OHIP refused this line because only one well-child exam for a child aged 2 to 5 is allowed in a 12-month period, and one was already paid.
After the second birthday, a check-up of a well child is a periodic health visit (K017 for family practice, K267 for paediatrics). The Schedule limits periodic health visits to one per patient per 12 months per physician, and visits over the limit are not insured (GP21).
Common causes
- A second well-child check-up within 12 months
- A visit for an illness billed as a well-child exam
How to fix it
- Find the date of the last paid well-child exam.
- If it was less than 12 months earlier, the second exam isn't payable.
- If the visit was for an illness or concern, send an RAI with the reason for the visit. Send it through eSubmit, or on form 0918-84, within 7 months of the RA date.
Don't resubmit if
- The visit was a routine exam less than 12 months after the last paid one.
- The claim is already on your Remittance Advice. 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