CARC 150: Payer deems the information submitted does not support this level of service.
The documentation didn't justify the E&M level (or other tier) billed. The carrier downcoded it.
CARC 150 is the code your insurance company used to explain why your claim was reduced, denied, or paid less than expected. It appears on your Explanation of Benefits (EOB) — the statement your plan sends after a claim is processed. Here's what it means for you and what you can do about it.
What CARC 150 means
The official X12 description is: “Payer deems the information submitted does not support this level of service.”
In plain language: The documentation didn't justify the E&M level (or other tier) billed. The carrier downcoded it.
Common scenarios
- E&M level 5 downcoded to level 4
- Critical-care time not documented
- Prolonged-service add-on
What to do next 150
Provider can submit additional chart documentation supporting the level billed. If the chart truly doesn't support it, the provider should rebill at the supported level.
DenialHelp drafts the appeal letter for you in about five minutes. We cite the federal appeal-rights regulation that applies to your plan type (ACA §2719, ERISA §503, NSA §2799A, 42 CFR 422 Subpart M, or 42 CFR 438 Subpart F), the insurer's own coverage policy, and the relevant clinical guideline.
CARC 150 group codes explained
On the 835 ERA, CARC 150 appears alongside a group code that signals who is financially responsible for the adjustment. CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
Frequently asked questions
What does CARC 150 mean?
Payer deems the information submitted does not support this level of service. In plain language: The documentation didn't justify the E&M level (or other tier) billed. The carrier downcoded it.
Is CARC 150 appealable?
Yes — CARC 150 is one of the codes that commonly supports an appeal. Provider can submit additional chart documentation supporting the level billed. If the chart truly doesn't support it, the provider should rebill at the supported level.
Which group code does CARC 150 appear under?
CARC 150 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
When does CARC 150 typically appear on a denial?
Common scenarios: E&M level 5 downcoded to level 4; Critical-care time not documented; Prolonged-service add-on.
How do I appeal a CARC 150 denial?
Provider can submit additional chart documentation supporting the level billed. If the chart truly doesn't support it, the provider should rebill at the supported level.
Related resources
Sources
Appeal a CARC 150 denial
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