Error report · Program-specific
OHIP error code R04
Service Excluded from RMBS
What R04 means
The Ministry of Health’s official wording for R04 is: “Service Excluded from RMBS.”
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 R04
This service is excluded from reciprocal medical billing - bill the patient's home province (or the patient) directly.
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
- EF9Mobile site number required
- R01Missing Health Service Number (HSN)
- R02Invalid HSN
- R03Invalid/Missing Province Code
- R05Provincial code invalid for RMBS Province code of 'ON' (Ontario) or ‘PQ’ (Quebec) and not an Outaouais claim
- R06Invalid Provider for RMBS
- R07Invalid Payment Type for RMBS
- R08Invalid Referral Number
Tired of decoding rejections by hand?
MedConcierge explains every rejection on your reports and helps you fix and resubmit in clicks. OHIP billing built by physicians, for physicians.
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.