CARC 212: Administrative surcharges are not covered.
Administrative surcharges are not covered.
CARC 212 appears on the 835 ERA (Electronic Remittance Advice) that the payer returns after claim adjudication. It explains a reduction, denial, or payment adjustment to your billing team. For your practice, the question is workflow: identify the pattern, route the denial to the right resolution path (rebill, appeal, write-off), and recover what's recoverable without burning RVU time on dead-end fights.
What CARC 212 means
The official X12 description is: “Administrative surcharges are not covered.”
In plain language: Administrative surcharges are not covered.
Practice workflow for CARC X 212
Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
CARC 212 group codes explained
On the 835 ERA, CARC 212 appears alongside a group code that signals who is financially responsible for the adjustment. CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
Frequently asked questions
What does CARC 212 mean?
Administrative surcharges are not covered. In plain language: Administrative surcharges are not covered.
Is CARC 212 appealable?
CARC 212 is usually not appealable on its own — it's typically a contractual, informational, or routine adjustment. Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
Which group code does CARC 212 appear under?
CARC 212 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
What should I do if I see CARC 212 on the 835?
Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
Related resources
Sources
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