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Error codes

Error codes and what they mean:

Level 1 Error Codes are errors returned by the MOH that can typically be corrected and resubmitted. These errors mean you have the opportunity to make the necessary changes to the claim and resubmit it for processing.

Level 2 Error Codes are errors identified and assessed by MOH. These errors appear on your Remittance Advice (RA). To request payment on these claims, you must submit a Request for payment by submitting an RAI with your documentation.

Error 35 (Level 1)
This error means payment has already been issued for this patient, date of service, and billing number. It may occur if a duplicate claim was submitted or if another claim with different service codes was already paid for the same date. This error cannot be disputed unless you can confirm that you were not paid on a previous Remittance Advice.

Error EH2 (Level 1)
Invalid Health Card: The health card used for the date of service is no longer valid and has a new version code. Contact the patient for their updated version code or contact Agent+ if you are signed up for the MOH PIN service and are on an Assisted or Full Service tier.

Error code 55/57 (Level 2)
Code 55: Shows a deduction or adjustment from a previous payment.
Code 57: Shows the corresponding payment adjustment for the previous account. These two codes are usually listed together, one after the other.

Special visit premiums (SVP’s) are not payable for:

  • Hospital or long-term care home rounds or elective admissions.
  • Visits to facilities (other than hospitals or long-term care homes) that are open to diagnose or treat patients.
  • Visits to non-referred or transferred obstetrical patients.
  • Patients seen without an appointment while the physician is already in the office, before, during, or after office hours.
  • Visits where a critical care team fee or per diem fee is payable
  • Emergency Department (ED) visits where an “H” prefix code is payable, except for the premiums listed in Special Visit Premium Table V for ED physicians called in when they are not scheduled to work and are not already at the hospital.
  • Services provided in conjunction with any sleep study listed in the Sleep Studies section of the Schedule.
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App Maintenance

App Maintenance

Unfinished Claims
Any unfinished claims are now being stored in the “In Progress” folder. Please refer to this folder as needed.

Agent+ Cleanup
Agent+ performs an annual audit to mass-settle claims that are no longer eligible for payment/dispute, helping keep your app organized and free of clutter. This will affect all billing tiers.

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Agent+ Portal

Agent+ Portal

If you have questions about your payments in addition to your app’s resolved folder you have access to our online portal, where you can view a digital copy of your Remittance Advice (RA) in an easy-to-read format.

Understanding your Agent+ RA

PARTIAL & NON-PAYMENTS: The Ministry of Health (MOH) has partially paid the fee service codes listed below. An explanatory error code has been provided.

MOH PAYMENT MODIFICATIONS: MOH has adjusted the payment amount for the fee service code listed below and has provided an explanatory code for the adjustment.

MOH ADJUSTMENTS: MOH has returned these claims on more than one remittance advice. The complete payment and adjustment history for each claim is displayed. This section will indicate whether there were any claw backs or returned RAI payments. Error codes 55/57 will typically appear in this section.

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New diagnostic code

New diagnostic code:

To support data collection efforts by Public Health Ontario, MOH has introduced diagnosis code 489 – RSV: Respiratory syncytial virus. This diagnostic code should be used with the appropriate assessment service fee code when a patient is diagnosed with RSV or administered (G538A) an immunization. It must be the primary reason for the visit.

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Provider Registration

Provider Registration

Effective April 1, 2026, the Ministry of Health moved to one submission process and is now only using electronic submissions.

Providers must now submit registration and update requests through the secure online portal for the following services: https://forms.mgcs.gov.on.ca/en/dataset/on00574

  • OHIP Billing Number registration
  • Health Care Group registration
  • Group membership and payment consent/authorization
  • Changes to address, banking, or group information
  • IVR participation applications Social Assistance Verification Portal PIN requests
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New Phone?

Reinstalling Agent+ on a New Phone – CANNOT USE BACKUP

If you get a new phone, do not use a backed-up version of the Agent+ app. Before switching over, make sure you submit any claims that are ready for submission from your old phone. Once you have restored your new phone from a backup, delete the Agent+ app from the new device. Then, download a fresh version of the Agent+ app from the App Store and log in using your existing credentials. Once you log in, all your Agent+ information will automatically import back into the app. This ensures you are using the current version of Agent+ and prevents issues that may occur when using a backed-up version of the app.

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Out of Canada?

Out of Canada

The Agent+ app cannot be used to submit claims while outside of Canada due to PHIPA requirements. However, you can still log into Agent+, create new claims, and save claims while travelling or working abroad. Any claims created or saved outside of Canada will remain available in the app, but claims cannot be submitted until you have returned to Canada. Once you are back in Canada, you can submit your completed claims through Agent+ as usual.

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Agent+ App Features you may not be aware of

Agent+ App Features you may not be aware of

Agent+ provides several tools to make OHIP billing faster and easier. While in the app, select any Fee Service Code and press and hold the code to view a complete description, helping you confirm the details and billing requirements before submitting a claim. The star icon at the bottom of the Services screen allows you to create and name your own custom code combinations, which can save time when billing frequently used service combinations. The Doctor’s Bag icon at the bottom of the Services screen provides a breakdown of Special Visit Premiums (SVPs) organized by department type, making it easier to identify the appropriate premium for your service. Please note that Special Visit Premiums can only be billed with “A” prefix service codes.

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Asking questions in app

Asking questions in app

Agent+ allows Assisted Service and Full-Service users to ask questions about a specific claim directly within the app. To submit a billing question, open the claim screen and scroll to the bottom of the claim, then select “Billing Question – Contact Agent+.” Enter your question in the provided text box and submit it to the Agent+ team for review. Once your question has been answered and the issue has been resolved, you must remove the billing question from the claim before submitting. If the question remains attached to the claim, the claim will continue to be marked as “In Progress” and will not be submitted to OHIP. Removing the question ensures the claim is returned to a ready-to-submit status.