RARC N116: This payment is being made conditionally because the service was provided in the home, and it is possible that the patient is under a home health episode of care.
Conditional payment — if a home health episode is active, this service should have been bundled.
What it means
The official X12 description: “This payment is being made conditionally because the service was provided in the home, and it is possible that the patient is under a home health episode of care.”
In plain language: Conditional payment — if a home health episode is active, this service should have been bundled.
What to do
Verify home health status. If patient was under episode, bundled payment applies.
Frequently asked questions
What does RARC N116 mean?
This payment is being made conditionally because the service was provided in the home, and it is possible that the patient is under a home health episode of care. In plain language: Conditional payment — if a home health episode is active, this service should have been bundled.
What should I do when I see RARC N116?
Verify home health status. If patient was under episode, bundled payment applies.
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Sources
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