CARC 241 — This amount reflects the reduced co-payment a patient owes under the Medicare P

CARC 241PR · Patient Responsibility

This amount reflects the reduced co-payment a patient owes under the Medicare Part D Low Income Subsidy program.

Common causes: The patient qualifies for the Low Income Subsidy, which caps their cost-sharing at a reduced, subsidized level.
Suggested fix: Bill the patient only the subsidy-adjusted co-pay amount shown; verify their subsidy status if the amount seems inconsistent.

Related Patient Responsibility codes

1The billed amount was applied to the patient's plan deductible instead of being paid by the payer.119The patient has used up the maximum benefit allowed for this service within the applicable time period, such as an annual visit limit.167The specific diagnosis code(s) on this claim aren't covered under the patient's plan.177The patient doesn't currently meet the plan's eligibility criteria for this benefit.187This amount was or should be paid from the patient's consumer-directed spending account, such as an HSA or FSA, rather than by the payer.2This portion of the claim represents the patient's coinsurance share, the percentage of the allowed amount they are responsible for under their plan.200The service date falls within a period when the patient's coverage had lapsed.201The patient is responsible for this amount under a legal set-aside arrangement, commonly seen in workers' compensation Medicare Set-Aside cases, rather than the payer.

Frequently asked questions

What does CARC 241 mean?

This amount reflects the reduced co-payment a patient owes under the Medicare Part D Low Income Subsidy program.

How do I resolve CARC 241?

Bill the patient only the subsidy-adjusted co-pay amount shown; verify their subsidy status if the amount seems inconsistent.

Why does CARC 241 happen?

The patient qualifies for the Low Income Subsidy, which caps their cost-sharing at a reduced, subsidized level.

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.