CARC 260CO · Contractual Obligation
This claim was processed and paid using an enhanced Medicaid primary care fee schedule.
- Common causes
- Applies to eligible primary care services under a temporary or state-continued Medicaid rate enhancement.
- Suggested fix
- No action is needed; confirm the provider and service qualify for the enhanced fee schedule if the payment seems lower than expected.
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 260 mean?
This claim was processed and paid using an enhanced Medicaid primary care fee schedule.
How do I resolve CARC 260?
No action is needed; confirm the provider and service qualify for the enhanced fee schedule if the payment seems lower than expected.
Why does CARC 260 happen?
Applies to eligible primary care services under a temporary or state-continued Medicaid rate enhancement.
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.