CARC 209CO · Contractual Obligation
The provider is contractually or legally prohibited from collecting this specific amount directly from the patient.
- Common causes
- Contract terms, dual-eligible patient protections, or balance-billing prohibitions restrict what can be collected from the patient.
- Suggested fix
- Don't bill the patient for this amount; write it off per the applicable agreement or regulation.
Related Contractual Obligation codes
107This claim depends on another related claim or service being referenced, but that link wasn't provided.11The diagnosis code doesn't support medical necessity for the procedure billed, based on the payer's coverage edits.13The claim shows a date of service after the patient's recorded date of death.146The diagnosis code billed wasn't a valid, active code as of the date of service.150The documentation submitted doesn't justify the complexity or level of the service billed, commonly seen with evaluation and management visit levels.16The claim is missing required information or contains a billing error that prevented the payer from processing it.170This payer doesn't reimburse this specific provider type for this service.171This payer doesn't cover this service when it's billed by this provider type in this particular facility setting.
Frequently asked questions
What does CARC 209 mean?
The provider is contractually or legally prohibited from collecting this specific amount directly from the patient.
How do I resolve CARC 209?
Don't bill the patient for this amount; write it off per the applicable agreement or regulation.
Why does CARC 209 happen?
Contract terms, dual-eligible patient protections, or balance-billing prohibitions restrict what can be collected from the patient.
CARC codes maintained by X12 (x12.org). Descriptions on this site are original reference interpretations. Always verify codes with authoritative sources before making billing decisions.