Error code
V6 — Initial assessment already billed - paid as minor assessment
Paid as minor assessment
An initial assessment was already paid for this patient, so this one was paid at the minor assessment fee.
What to do: Check the history for the earlier initial assessment; if within the limit period, bill a follow-up code for later visits.
- Code
- V6
- Description
- Initial assessment already billed - paid as minor assessment
Explanation
Updated October 26, 2026
An initial assessment was already paid for this patient, so this one was paid at the minor assessment fee instead.
What it means
The Ministry's wording for V6 is "Allowed as minor assessment-initial assessment already claimed". OHIP found an earlier initial-level assessment for the same patient and paid this claim at the minor assessment rate.
Initial-level assessments are limited, and services over the limit are paid at a lesser fee (GP21–GP25). With V6, the lesser fee OHIP applied is the minor assessment.
Common causes
- An initial-level assessment was billed again for a patient who already had one paid within the limit
- The visit was for a different problem, but the claim did not make that clear
How to fix it
- Check the patient's claim history for the earlier initial assessment.
- If it was within the limit period, the lower payment is expected. Bill the appropriate follow-up code for later visits.
- If the visit met the rules for a second initial assessment, keep the chart notes that show this.
- If you believe the payment is wrong, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date, with supporting details.
Don't resubmit if
- The claim is already on the RA. Use an RAI, not a new claim, if you disagree with the payment.
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