N873Remark Code (RARC)ActiveInformational Alert
N873 Remark Code: Payment Based on No Surprises Act
The N873 remark code indicates that the final payment has been determined based on an All-Payer Model Agreement, as mandated by the No Surprises Act. This alert serves to inform providers about the payment calculation method but does not result in any adjustments to claims.
What This Alert Tells You
As an informational alert, N873 is not linked to any specific adjustment or reason code. It is designed to provide clarity regarding payment calculations under the All-Payer Model Agreement and should be recognized as part of the remittance advice process.
Common Scenarios
1A provider submits a claim for a service covered under the No Surprises Act and receives an 835 remittance that includes the N873 remark code.
→ In this case, the N873 remark indicates that the payment was calculated according to the All-Payer Model Agreement, ensuring compliance with the No Surprises Act.
2A facility receives payment for an emergency service and sees the N873 alert on their remittance advice, indicating the payment method used.
→ The presence of the N873 remark informs the facility that the payment was calculated based on the All-Payer Model Agreement, highlighting adherence to the No Surprises Act.
3A claim for a high-cost procedure is processed, and the provider notices the N873 alert on the remittance advice.
→ The N873 remark clarifies that the payment amount is determined in accordance with the All-Payer Model Agreement, reflecting the protections established by the No Surprises Act.
What to Do
- Do not take any action based on this alert, as it is informational only.
- Expect that payment calculations are compliant with the No Surprises Act.
What to Check
- Review the remittance advice for accompanying details about the All-Payer Model Agreement.
- Check the payment amount against standard rates in your billing system.
- Confirm that the service billed falls under the protections of the No Surprises Act.