Medicare Administrative Contractors (MACs) Part B, the Multi- Carrier System (MCS) and Durable Medicare Equipment (DME) MACs Updates on Processing Medicare Secondary Payer (MSP) Claims Containing Certain Claim Adjustment Reason Codes (CARCs)
Contractors (MACs) on how to process MSP claims containing certain CARCs as identified in this CR. Part B and DME MACs process MSP claims containing CARCs based on previous CMS instructions. Over the years, many of these CARCs were processed through automation, denied, or suspended for manual review. However, after recent discussions held with the Part B MACs, several CARCs can now be processed through automation without manual intervention while others will continue to be suspended. The change request identifies those CARCs codes that will be processed through automation and those that will be suspended for manual review or even denied.
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: March 31, 2026
DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.