OHIP error report·AEV
OHIP error code AEV: visit only allowed
OHIP rejected the claim because only a visit is allowed for that service. The consultation or other non-visit code you submitted is not payable on this claim.
Most often affects Internal medicine, Psychiatry, Neurology, Hospitalists, Orthopaedic surgery.
The one-line answer
OHIP rejected the claim because only a visit is allowed for that service. The consultation or other non-visit code you submitted is not payable on this claim.
Ministry wording: Visit only allowed.
Why it fires
- A consultation was billed where the Ministry will only pay a visit for that encounter.
- The documented service is an assessment or follow-up visit, but the claim used a consult listing.
- The claim combined a non-visit code with an encounter that the edit treats as visit-only.
The Ministry-aligned error list labels AEV in three words: visit only allowed. That is the entire official condition. It sits on the Claims Error Report, which means the item is rejected before payment, not quietly paid at a lower rate on the remittance advice.
In specialist practice the usual fact pattern is a consultation code on a claim the Ministry will not pay as a consult. The Schedule’s consultation rules still matter here even though they are not printed on the AEV line. A consultation requires a written request from a referring physician or nurse practitioner, a consultative opinion, and a written report. The Ministry’s own billing-education material states that without a written request the consultation is paid as an assessment. AEV is the error-report form of “this is not payable as the non-visit code you sent.”
AEV is therefore the highest-stakes referral-integrity reject for many consultants. The difference between a consult listing and a limited or general assessment is large and repeats every time the same documentation gap is billed as a consult. Treat AEV as a documentation and code-selection problem, not as a random systems glitch.
What it costs
The submitted code is rejected. No consult fee is paid on that claim. A correctly submitted visit or assessment may be payable instead. The dollar gap is the difference between those listings, which varies by specialty and cannot be stated as one figure.
Physicians often notice AEV late because the clinical day felt like a consult. The error report disagrees. Until you resubmit a payable visit listing (or a consult that actually meets consult rules), the encounter is unpaid.
This is not a percentage write-off we can quote. It is a full reject of the line you submitted. The replacement visit, if you bill one, pays the visit fee, not the consult fee.
How to fix it going forward
- Bill a consultation only when the record includes a written request from an eligible referring provider, a consultative assessment, and a written report back.
- Use the assessment or follow-up visit listing when the patient is already in your practice for the same problem without a new request.
- Do not upgrade a visit to a consult because the appointment ran long or the referring note was verbal only.
- Reconcile error reports weekly so visit-only rejects are resubmitted as visits while the three-month window is open.
The prevention that lasts is matching the listing to the paper. If there is no signed consult request in the chart, do not send a consult code. That single rule removes most specialist AEV.
Track AEV by physician. A provider who generates AEV every week usually has a template defaulted to consult. Change the default to the assessment that matches their actual mix, and require an extra click for true new consults.
Is it recoverable?
Recoverable by resubmission inside the window
Resubmit the payable visit or assessment listing that matches the record, or a consultation only if the written request and report are present, inside the three-month window from the date of service.
If the chart supports a consult, fix the claim so it is a consult the Ministry can accept (eligible referrer, request on file). If the chart supports only a visit, bill the visit. Repeating the original consult code reproduces AEV.
After the three-month window, an unpaid encounter may be recoverable by written application. The application still has to match a listing you were eligible to claim. It is not a method for converting visits into consults.
For in-province services on or after 1 April 2023, claims must be submitted within three months of the date of service, not six. Ontario INFOBulletin 230402 is the Ministry notice. Many third-party pages still quote six months. That window is closed for current work. If the original claim reached the Claims Error Report inside three months, a corrected resubmission can still be filed after the window in the Ministry's stale-date process. If the claim was never submitted in time, payment may be recoverable by written application. That is not a routine resubmit.
Related codes
Frequently asked questions
- What does OHIP error code AEV mean?
- AEV means visit only allowed. The Claims Error Report rejected the code you submitted because OHIP will only pay a visit for that service, not the consultation or other non-visit listing on the claim.
- Is AEV a silent payment of an assessment on the remittance advice?
- No. AEV is an error-report rejection, so that line is not paid in that run. A related Schedule rule can pay an unsupported consultation as an assessment on the remittance advice under a different process. Read both the error report and the RA.
- When is a specialist consultation payable instead of a visit?
- When the service meets the consultation definition in the Schedule, including a written request from an eligible referring physician or nurse practitioner and a written report. If those elements are missing, bill the visit or assessment that matches the record.
For how error reports relate to the remittance advice, see how to read your OHIP remittance advice and what rejection codes actually mean. Official wording for this code: OHIP Claims Error Report code list (Dr.Bill ministry-aligned reference).