CARC 45: Charge exceeds the allowed amount
Your charge is higher than the payer's allowed amount under your contract or fee schedule. The difference is adjusted off.
Group code context
Usually sent with group code CO (contractual obligation): under your contract you cannot bill the patient for this amount.
Common causes
- Normal for most claims: billed charges are set above contracted rates
Step-by-step fix
- Check the allowed amount matches your contract
- Post the contractual adjustment
- Bill the patient only their share (deductible, copay or coinsurance), not the difference
Appeal guidance
Appeal only if the payer paid below your contracted rate.
When not to appeal
Do not appeal a normal contractual adjustment.
Prevention checklist
- Load contracted fee schedules into your PM system
- Compare payments to contract rates every month to catch underpayments
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.