How do I fix OHIP error code EPS?

Read the eligibility rules for the code you billed. Check the patient against them for the service date. If a different code applies, correct the claim and resubmit.

When shouldn't I resubmit a EPS claim?

The patient doesn't meet the program's criteria.

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Error code

EPS — Patient Not Eligible for Program

Q: What does OHIP error code EPS mean?

EPS means the patient isn't eligible for the program the code belongs to. Check the code's eligibility rules before resubmitting.

Patient not eligible for program

The patient wasn't eligible for the program tied to the fee code billed.

What to do: Check the patient against the code's eligibility rules for the service date; if a different code applies, resubmit with it.

Code: EPS
Description: Patient Not Eligible for Program

Explanation

Updated October 26, 2026

EPS means the patient isn't eligible for the program the code belongs to. Check the code's eligibility rules before resubmitting.

What it means

EPS means the patient was not eligible for the program tied to the fee code billed, so the claim was rejected. The Ministry's error list doesn't name the programs.

Common causes

The patient doesn't meet the program's criteria, for example the age range or income support status required for the Appendix F eye exams K065 and K066 (ages 20 to 64, on ODSP or Ontario Works)
The wrong code was billed

How to fix it

Read the eligibility rules for the code you billed.
Check the patient against them for the service date.
If a different code applies, correct the claim and resubmit.

Don't resubmit if

The patient doesn't meet the program's criteria.

How APEX handles it

APEX reads your error reports and remittance advice from MCEDT and lists claims rejected with this code in its Correction Centre for you to correct and resubmit. See how APEX works · Pricing

Related codes: EPP