CARC 5: Procedure code or bill type does not match the place of service
The service code does not fit the place of service on the claim.
Group code context
Usually sent with group code CO (contractual obligation): under your contract you cannot bill the patient for this amount.
Common causes
- Office place of service (11) used for a hospital or facility visit
- Telehealth place of service (02 or 10) missing or wrong
- Facility code billed with a professional place of service
Step-by-step fix
- Confirm where the service actually happened
- Correct the place of service code
- Send a corrected claim
Appeal guidance
Appeal only when the place of service was correct and the payer is wrong.
When not to appeal
Do not appeal a wrong place of service code. Correct and resubmit.
Prevention checklist
- Map each location in your PM system to the right place of service code
- Have a separate telehealth workflow
Related codes
CARC 4: Modifier missing or inconsistent with the procedure code
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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.