How do I fix OHIP error code I6?

Check which line has I6 and whether the main service on the visit was paid. Compare the visit with the premium's conditions in the Schedule of Benefits or your agreement: patient enrolment, date and time, and eligible fee codes. If the premium didn't apply, there is nothing to fix. The main service stands. If the whole visit came back at $0, review how it was billed. A corrected claim with the right visit code may be needed. If you believe the premium did apply, for example the patient was enrolled on that date, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.

When shouldn't I resubmit a I6 claim?

The main service was paid and only the premium was refused. Sending the visit again would duplicate it. The visit was on a weekday between 8 a.m. and 5 p.m. and you billed the after-hours premium. You want to dispute I6 on a paid claim. Use an RAI.

< Error codes

Error code

I6 — Premium not applicable

Q: What does OHIP error code I6 mean?

OHIP refused a premium on this claim because the premium's conditions weren't met. Check whether the main service was still paid.

Premium not payable

A premium on the claim, such as after-hours Q012A, wasn't paid because its conditions weren't met; the main service may still stand.

What to do: Check whether the main service was paid, then compare the visit with the premium's enrolment, time and fee code conditions.

Code: I6
Description: Premium not applicable

Explanation

Updated October 26, 2026

OHIP refused a premium on this claim because the premium's conditions weren't met. Check whether the main service was still paid.

What it means

I6 means a premium billed on the claim was not paid because OHIP found it did not apply. A premium is an add-on paid on top of an eligible service, such as the primary care after-hours premium Q012A.

Premiums have their own conditions. For example, the after-hours premium is only for enrolled patients seen in regularly scheduled after-hours sessions: after 5 p.m. on weekdays, or any time on weekends and statutory holidays. It can't be claimed for services between 8 a.m. and 5 p.m.

I6 often sits on the premium line next to a visit that was paid, or shadow billed under I2. In that case only the premium was refused and the visit itself stands.

Common causes

An after-hours premium (Q012A) billed for a weekday daytime visit
A premium billed for a patient who isn't enrolled with you
A premium billed on a claim that doesn't meet its other conditions, such as a regularly scheduled after-hours session

How to fix it

Check which line has I6 and whether the main service on the visit was paid.
Compare the visit with the premium's conditions in the Schedule of Benefits or your agreement: patient enrolment, date and time, and eligible fee codes.
If the premium didn't apply, there is nothing to fix. The main service stands.
If the whole visit came back at $0, review how it was billed. A corrected claim with the right visit code may be needed.
If you believe the premium did apply, for example the patient was enrolled on that date, send a Remittance Advice Inquiry (RAI) through eSubmit, or on form 0918-84, within 7 months of the RA date.

Don't resubmit if

The main service was paid and only the premium was refused. Sending the visit again would duplicate it.
The visit was on a weekday between 8 a.m. and 5 p.m. and you billed the after-hours premium.
You want to dispute I6 on a paid claim. Use an RAI.

How APEX handles it

APEX fixes I6 automatically only when nothing on the visit was paid: for Q012A billed with Q888A, it proposes resubmitting the visit as A007A (keeping Q023A if billed), with a related fix for virtual visits. Visits where the main service was paid or shadow billed and only the premium got I6 are left alone, since there is nothing to fix. See how APEX works · Pricing

Related codes: IA, I2, V4