Error code
V7 — Allowed at medical/specific re-assessment fee
Paid as a re-assessment
The specific assessment was paid at the lower re-assessment fee because this patient already had one from you within 12 months.
What to do: Nothing to do if the earlier assessment was for the same problem; bill a re-assessment code next time.
- Code
- V7
- Description
- Allowed at medical/specific re-assessment fee
Explanation
Updated October 26, 2026
OHIP paid this assessment at the medical/specific re-assessment fee because the limit for full specific assessments was reached. Usually no action.
What it means
Code V7 means a specialist's specific assessment or medical specific assessment was paid at the lower re-assessment fee.
The Schedule limits specific and medical specific assessments to one per patient per physician in 12 months. A second one is allowed when the patient comes back with a clearly different, unrelated diagnosis, or (for a medical specific assessment) when at least 90 days have passed and the second is a hospital admission assessment. Above the limit, the payment is cut to a lesser assessment fee (Schedule GP23). An admission assessment can also be treated as a re-assessment when the same physician assessed the patient for the same illness before admission (GP23 commentary).
Common causes
- A second specific assessment for the same problem within 12 months
- An admission assessment for a patient you had already assessed for the same illness
How to fix it
- Check the patient's earlier assessments by you in the 12 months before this one.
- If the reduction is right, there is nothing to fix. Bill a re-assessment code next time.
- If this visit was for a clearly different, unrelated diagnosis, check that the diagnostic code on the claim shows that. 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
- You disagree with how a claim already on the RA was paid. 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