How does RARC N16 pair with CARCs?

RARC N16 is a remark code that appears alongside CARCs on the 835 electronic remittance advice to provide detail about the adjustment.

RARC N16: Family/member Out-of-Pocket maximum has been met. Payment ba

Family/member Out-of-Pocket maximum has been met. Payment based on a higher percentage.

Code type RARC (Remark)

Category Reference

See the full resolution workflow for RARC N16

Members of the EDI-Code Intelligence Lab get the step-by-step rework path, appeal language, root-cause drivers, and prevention checklist for every RARC and CARC pairing, plus payer-specific requirements.

Open in EDI Lab

RARC N16: Family/member Out-of-Pocket maximum has been met. Payment based on a higher percentage.

See the full resolution workflow for RARC N16