CO-24
Charges covered under a capitation agreement/managed care plan
What This Code Means
The service is included in a capitated payment arrangement, so no additional fee-for-service payment applies.
Common Causes
- Patient is enrolled under a capitation arrangement with this provider/group
- Service billed fee-for-service in error
How to Resolve or Appeal
- Confirm the capitation agreement covers this service
- Do not bill the patient beyond any applicable cost-share
More Denial Codes to Check
Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.