Remittance Advice · Payment-time (remittance)
OHIP explanatory code 69
Elective Services Paid At 75% Of OHIP Schedule of Rates
What 69 means
The Ministry of Health’s official wording for 69 is: “Elective Services Paid At 75% Of OHIP Schedule of Rates.”
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 69
The fee was reduced or capped under this rule. If you believe the full amount was payable, file a Remittance Advice Inquiry with supporting detail.
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
- 60Not a benefit of the Reciprocal Medical Billing Agreement
- 62Claim assessed by Assessment Officer
- 65Service included in approved hospital payment
- 66Reduced per Alternative Payment Program (APP) Funding Contract
- 70OHIP records show corresponding procedure(s) on this day claimed previously by another physician
- 80Technical fee adjustment for hospitals
- AHNot allowed in addition to health exam
- APThis payment is in accordance with legislation. If you disagree with the payment, you may appeal to the General Manager
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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.