How do I fix OHIP error code EPA?

Find the code on the claim that is limited to enrolment-model physicians, usually a Q code. If the physician is a member of the group, resubmit under the correct group number. Check their affiliation dates if it still rejects. If the physician isn't eligible, remove that code and resubmit the remaining services as fee-for-service. If nothing payable is left once the code is removed, don't resubmit.

When shouldn't I resubmit a EPA claim?

The physician isn't affiliated with an enrolment group on the service date and the claim still contains the restricted code. The only code on the claim is the restricted code and the physician isn't eligible for it.

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Error code

EPA — Network billing not approved

Q: What does OHIP error code EPA mean?

EPA means the claim includes a code reserved for physicians in a primary care enrolment model, and you aren't approved to bill it under this number.

Not approved for network billing

The claim has a code reserved for enrolment-model physicians, usually a Q code, and you aren't approved to bill it under this number.

What to do: If the physician belongs to the group, resubmit under the correct group number; otherwise remove that code.

Code: EPA
Description: Network billing not approved

Explanation

Updated October 26, 2026

EPA means the claim includes a code reserved for physicians in a primary care enrolment model, and you aren't approved to bill it under this number.

What it means

'Network' is the Ministry's older term for a primary care enrolment group (it was once a Primary Care Network, or PCN). Some fee codes are only payable to physicians who belong to such a group, such as Q-prefixed primary care codes and the FHO+ hourly codes.

EPA means the Ministry's records don't show the billing physician approved to bill that code under the billing number and group used, on the service date.

For example, INFOBulletin 260309 says that a physician who is not affiliated with an FHO and bills the hourly codes Q310A to Q313A gets EPA. FHO locums must bill hourly codes under the FHO group number.

Common causes

A Q code for enrolment-model physicians billed by a physician who isn't in that model.
An FHO locum billing hourly codes without the FHO group number.
A new group member whose affiliation wasn't active yet on the service date.
Billing software applying a group's Q codes to a non-member's claims.

How to fix it

Find the code on the claim that is limited to enrolment-model physicians, usually a Q code.
If the physician is a member of the group, resubmit under the correct group number. Check their affiliation dates if it still rejects.
If the physician isn't eligible, remove that code and resubmit the remaining services as fee-for-service.
If nothing payable is left once the code is removed, don't resubmit.

Don't resubmit if

The physician isn't affiliated with an enrolment group on the service date and the claim still contains the restricted code.
The only code on the claim is the restricted code and the physician isn't eligible for it.

How APEX handles it

For family practice claims, APEX removes the Q codes and resubmits the rest of the claim. A claim made up only of Q codes, such as FHO+ hourly codes, is listed for you to correct instead. See how APEX works · Pricing

Related codes: EPC, EP5, EQE, EQF, 31