CARC 3: Co-payment amount
This is the patient's fixed copay for the visit or service, which the patient owes.
Group code context
Usually sent with group code PR (patient responsibility): the amount is owed by the patient, not written off.
Common causes
- Copay not collected at check-in
- Specialist or urgent care copay differs from the primary care copay
Step-by-step fix
- Compare with the copay shown on eligibility
- Post as patient responsibility
- Collect from the patient or apply the payment taken at check-in
Appeal guidance
Appeal only if the wrong copay tier was applied.
When not to appeal
Do not appeal a correct copay.
Prevention checklist
- Collect copays at check-in
- Check whether the visit type has a different copay
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.