Remittance Advice · Payment-time (remittance)
OHIP explanatory code 65
Service included in approved hospital payment
What 65 means
The Ministry of Health’s official wording for 65 is: “Service included in approved hospital payment.”
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 65
Informational - the claim was paid (sometimes at an adjusted amount). No action needed unless the amount looks wrong, in which case file a Remittance Advice Inquiry.
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
- 58Claimed by another physician within group
- 59Practitioner's notification - WCB claims
- 60Not a benefit of the Reciprocal Medical Billing Agreement
- 62Claim assessed by Assessment Officer
- 66Reduced per Alternative Payment Program (APP) Funding Contract
- 69Elective Services Paid At 75% Of OHIP Schedule of Rates
- 70OHIP records show corresponding procedure(s) on this day claimed previously by another physician
- 80Technical fee adjustment for hospitals
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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.