Remittance Advice · Payment-time (remittance)
OHIP explanatory code M1
Maximum fee allowed or maximum number of service has been reached same/any provider
What M1 means
The Ministry of Health’s official wording for M1 is: “Maximum fee allowed or maximum number of service has been reached same/any provider.”
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 M1
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
- L8Not to be claimed with prenatal/fetal assessment
- L9Laboratory services for hospital in-patients or out-patients are not payable on a fee-for-service basis-included in the hospital global budget
- LALab service is funded by special Lab Agreement
- LSPaid in accordance to special Lab Agreement
- M2Maximum allowance for radiographic examination(s) by one or more practitioners
- M3Maximum fee allowed for prenatal care
- M4Maximum fee allowed for these services by one or more practitioners has been reached
- M5Monthly maximum has been reached
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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.