Patient is responsible for amount of this claim/service through 'set aside arrangement' or other agreement. (Use only with Group Code PR). At least one Remark Code must be provided (may be comprised of either the NCPDP Reject Reason Code, or Remittance Advice Remark Code that is not an ALERT.)
Group code
PR
Category
Benefit Maximum/Limitation
Risk level
Medium
Appealable
Review Required
Common RARC pairings
RARCs (Remittance Advice Remark Codes) provide the specific reason detail alongside CARC 201 on the 835 electronic remittance. These are the RARCs seen most often with this CARC.
| RARC | Meaning |
|---|---|
| N722 | Patient must use Workers' Compensation Set-Aside (WCSA) funds to pay for the medical service or item. |
| N723 | Patient must use Liability set-aside (LSA) funds to pay for the medical service or item. |
| N724 | Patient must use No-Fault set-aside (NFSA) funds to pay for the medical service or item. |
| N897 | Missing/incomplete/invalid proof of member payment. |
See the full resolution workflow for CARC 201
Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every CARC and RARC pairing, plus payer-specific quirks.
Open in EDI Lab