CARC 194: Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable.
Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable.
CARC 194 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 194 means
The official X12 description is: “Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable.”
In plain language: Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable.
What to do next 194
Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
CARC 194 group codes explained
On the 835 ERA, CARC 194 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 194 mean?
Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable. In plain language: Anesthesia performed by the operating physician, the assistant surgeon, or the attending physician is not separately payable.
Is CARC 194 appealable?
CARC 194 is usually not appealable on its own — it's typically a contractual, informational, or routine adjustment. Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
Which group code does CARC 194 appear under?
CARC 194 most often appears under: CO (Contractual Obligation) — Contractual write-off. The provider agreed to the rate. Patient does NOT owe this amount.
What should I do if I see CARC 194 on the 835?
Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
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