Error code
V9 — Only 1 initial office visit allowed within 12 months
Initial visit limit reached
Only one initial office visit is allowed per patient in 12 months, and this claim went over that limit.
What to do: Check the patient's visits in the previous 12 months; if this one was a correctly billed follow-up, there is nothing to fix.
- Code
- V9
- Description
- Only 1 initial office visit allowed within 12 months
Explanation
Updated October 26, 2026
OHIP limits this initial office visit to one per 12 months for the patient. The line was refused or reduced. Check for an earlier initial visit.
What it means
Code V9 means the Ministry allows only one initial office visit within a twelve-month period, and this claim went over that limit.
The Ministry's description gives no more detail, and the current Schedule of Benefits for physicians doesn't use the phrase "initial office visit".
Common causes
- An earlier initial visit for the same patient within 12 months
How to fix it
- Check the patient's earlier visits in the 12 months before this one.
- If a second visit was correctly billed as a follow-up, there is nothing to fix.
- 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