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CARC
PR-2
CARC
PR — Patient Responsibility
Non-Covered
Quick Facts
Code
PR-2
Type
CARC
Category
Non-Covered
Status
Active
Coinsurance amount
What Does This Code Mean?
The amount applied is the patient’s coinsurance — their percentage share of the allowed amount after the deductible is met.
Common Causes
- Standard plan cost-sharing structure
- Coinsurance percentage varies by service type or network status
Recommended Next Steps
- Confirm the coinsurance percentage matches the patient's plan summary
- Bill the patient their coinsurance share
- Flag repeated high coinsurance balances for the patient's own review with their plan
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Educational reference only — not medical or legal advice. Always confirm code usage and appeal rights with the specific payer.