< Error codes

Error code

51 — Fee code changed per the Schedule of Benefits

Paid under different code

OHIP changed the fee code to the one the Schedule of Benefits says applies and paid that code instead.

What to do: Compare the code and amount paid with what you billed; if OHIP's code is right, fix your code choice.

Code
51
Description
Fee code changed per the Schedule of Benefits

Explanation

Updated October 26, 2026

OHIP paid this line under a different fee code from the one you billed, because the Schedule of Benefits calls for that code. Check which code was paid.

What it means

Code 51 is an explanatory code on the Remittance Advice (RA). It means OHIP changed the fee schedule code on the claim to the one the Schedule of Benefits says applies, and paid that code instead. The claim was accepted, but the code or the amount on the line may differ from what you sent.

It sits beside other payment codes. C2 means the service was allowed at the re-assessment fee. 09 means the fee code used isn't correct and asks you to resubmit with the right code, or send an inquiry if the claim is already on the RA.

Whether you should act depends on the chart. If the substituted code matches what was done and documented, the payment stands. If the code you billed was right, ask for a review.

Common causes

  • The fee code doesn't match where the service was given. The Schedule uses different prefixes for office, hospital in-patient, long-term care and emergency department visits (GP12).
  • A higher-level service billed when its requirements weren't met, so a lower code applies
  • An out-of-date code or code setting in the billing software

How to fix it

  1. Compare the fee code and amount paid with what you billed.
  2. Read the Schedule listing for both codes and compare them with what is documented in the chart.
  3. If OHIP's code is the right one, there is nothing to resubmit. Fix the code choice or software setting so the next claim goes in correctly.
  4. If you believe your original code was correct, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the date of the RA the claim appears on. Include the clinical notes that show the billed code's requirements were met.
  5. The Ministry answers on the RAI: paid correctly, adjustment required, or final decision. If the answer isn't marked final, keep the same inquiry going by sending new information. Don't open a second RAI for the same claim.

Don't resubmit if

  • The claim is on the RA. A new claim for the same service would be a duplicate; changes go through an RAI.
  • The chart doesn't support the code you originally billed.

How APEX handles it

APEX shows 51 on the claim line and has no correction rule for it. A line that was paid something is not added to the Correction Centre. If nothing on the visit was paid, the visit is listed under Outstanding for you to review; APEX never sends it on its own. If you are handling it through an RAI instead, use Ignore on it so it isn't sent again as a new claim. See how APEX works · Pricing

Related codes: 09, 50, 53, C2

Sources