CARC 24CO · Contractual Obligation
The provider is paid a flat periodic amount for this patient under a capitation agreement, so this specific service isn't paid separately.
- Common causes
- The rendering provider has a capitated contract with the payer or a managed care organization covering this type of service.
- Suggested fix
- No separate payment is expected; confirm the capitation agreement covers this service, and don't bill the patient beyond any applicable cost-share.
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 24 mean?
The provider is paid a flat periodic amount for this patient under a capitation agreement, so this specific service isn't paid separately.
How do I resolve CARC 24?
No separate payment is expected; confirm the capitation agreement covers this service, and don't bill the patient beyond any applicable cost-share.
Why does CARC 24 happen?
The rendering provider has a capitated contract with the payer or a managed care organization covering this type of service.
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.