Remittance Advice · Payment-time (remittance)
OHIP explanatory code 45
Specialty code restriction on Fee Schedule Code
What 45 means
The Ministry of Health’s official wording for 45 is: “Specialty code restriction on Fee Schedule Code.”
This code appears as an explanatory code on your monthly Remittance Advice (RA). It means the claim was adjudicated — paid, reduced, or refused — for the reason below. A claim already on your RA generally shouldn't be blindly resubmitted; follow the suggested action.
How to fix 45
This explains a payment adjustment. If you believe the claim was billed correctly, file a Remittance Advice Inquiry within the deadline; otherwise no resubmission is needed.
Payment-time codes appear on the monthly Remittance Advice after adjudication. Some are informational, some explain a reduced or refused payment. Where you disagree with the outcome, the usual route is a Remittance Advice Inquiry or written inquiry — not resubmitting the same claim, which can create a duplicate.
Related codes
- 37Effective April 1, 1993 the listed benefit for this code is 0 Laboratory Medicine Services (LMS) units
- 40Service or related service allowed only once for same patient
- 41Fee Schedule Code (FSC) Billed - No Evidence in Supporting Documentation Provided
- 42FSC Billed Included in Other Procedure
- 46Paid Per 2nd Review by Medical Advisor (MA)
- 47Not Paid Per 2nd Review by Medical Advisor (MA)
- 48Paid as submitted - clinical records may be requested for verification purposes
- 49Paid according to the average fee for this service. Independent consideration will be given if clinical records/operative reports presented.
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Code meaning per Ontario Ministry of Health — Remittance Advice Explanatory Codes / Messages (March 2026). The suggested action is general information for Ontario physicians, not billing, legal, or tax advice — codes and rules change, so verify against the current Ministry of Health documents before relying on a claim.