CARC 211: National Drug Code (NDC) not eligible for rebate, do not bill.
National Drug Code (NDC) not eligible for rebate, do not bill.
CARC 211 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 211 means
The official X12 description is: “National Drug Code (NDC) not eligible for rebate, do not bill.”
In plain language: National Drug Code (NDC) not eligible for rebate, do not bill.
What to do next 211
Verify the EOB details. If you believe the code is misapplied, contact the carrier's member services or your provider's billing office.
CARC 211 group codes explained
On the 835 ERA, CARC 211 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 211 mean?
National Drug Code (NDC) not eligible for rebate, do not bill. In plain language: National Drug Code (NDC) not eligible for rebate, do not bill.
Is CARC 211 appealable?
CARC 211 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 211 appear under?
CARC 211 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 211 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.
Related resources
Sources
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