Remittance Advice · Payment-time (remittance)
OHIP explanatory code 60
Not a benefit of the Reciprocal Medical Billing Agreement
What 60 means
The Ministry of Health’s official wording for 60 is: “Not a benefit of the Reciprocal Medical Billing Agreement.”
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 60
Not payable by OHIP under this rule - bill the patient or the correct payer if the service is uninsured, or file a Remittance Advice Inquiry if you believe it qualifies.
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
- 56Claim under review
- 57This payment is an adjustment on an earlier account
- 58Claimed by another physician within group
- 59Practitioner's notification - WCB claims
- 62Claim assessed by Assessment Officer
- 65Service included in approved hospital payment
- 66Reduced per Alternative Payment Program (APP) Funding Contract
- 69Elective Services Paid At 75% Of OHIP Schedule of Rates
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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.