Error report · Program-specific
OHIP error code EF5
ICHSC practitioner 991000 is not allowed to bill insured services
What EF5 means
The Ministry of Health’s official wording for EF5 is: “ICHSC practitioner 991000 is not allowed to bill insured services.”
This code appears on your Claims Error Report (downloaded through MCEDT). It means the claim was rejected at submission and was never adjudicated for payment — fix the issue below and resubmit the claim.
How to fix EF5
Practitioner number 991000 can't bill insured services - bill insured services under the correct provider number, then resubmit.
Program-specific codes come from claims routed through special programs — Reciprocal Medical Billing for out-of-province patients, WSIB, telemedicine/virtual care, and Integrated Community Health Services Centres. The fix depends on that program's own submission rules.
Related codes
- EF1ICHSC number not approved for billing on the date specified
- EF2ICHSC not licensed or grandfathered to bill FSC on the date specified
- EF3Insured services are excluded from ICHSC billings
- EF4Provider is not approved to bill ICHSC fee on date specified
- EF7Referring physician number is required for the ICHSC fee billed
- EF8'I' service codes are exclusive to ICHSCs
- EF9Mobile site number required
- R01Missing Health Service Number (HSN)
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Code meaning per Ontario Ministry of Health — Error Report Rejection Conditions / Error Codes (December 2022). 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.