CARC 1: Deductible amount
The payer applied this amount to the patient's deductible, so the patient owes it instead of the plan.
Group code context
Usually sent with group code PR (patient responsibility): the amount is owed by the patient, not written off.
Common causes
- The patient has not met the plan's annual deductible yet
- High-deductible health plan early in the plan year
Step-by-step fix
- Confirm the amount matches the deductible shown in the eligibility response
- Post the amount as patient responsibility
- Bill the patient, or apply any payment collected at the visit
Appeal guidance
There is nothing to appeal unless the deductible was applied by mistake, for example after the patient already met it. In that case, send the payer proof of the met deductible.
When not to appeal
Do not appeal a correctly applied deductible. Collect it from the patient.
Prevention checklist
- Check remaining deductible during eligibility verification
- Give patients a cost estimate before non-urgent services
- Collect a deposit for high-deductible patients
Related codes
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Source and review
Official source ↗Last checked: 2026-10-05
Reviewed by: PracticeVendors editorial team
Educational reference. Confirm payer instructions and applicable contracts before taking action.