N908Remark Code (RARC)Active
N908 Remark Code - No Refund for Maximum Fair Price
The N908 remark code indicates that no refund is required for a drug that has been purchased prospectively at the maximum fair price. This suggests that the payer is adhering to the Medicare Drug Price Negotiation Program, which affects pricing and reimbursement policies for certain drugs.
How It Relates to the Denial
The N908 remark typically accompanies adjustment reason codes related to drug pricing, particularly when a claim has been adjusted due to the Medicare Drug Price Negotiation Program. The combination signals that the payer has determined the drug's price has already been negotiated and set, thus no further refund is applicable.
Common Scenarios
1A pharmacy billed for a prescription drug that is part of the Medicare Drug Price Negotiation Program.
→ The N908 remark indicates that the payer has determined the drug was purchased at the maximum fair price, and therefore, no refund is necessary.
2A healthcare provider submitted a claim for a medication and received an adjustment that referenced the negotiated price under Medicare.
→ The presence of the N908 remark means the payer confirms that the maximum fair price applies to this drug, and no additional refund will be issued.
3A claim for a drug was denied due to pricing issues, but the remittance included N908 along with an adjustment reason code.
→ This remark clarifies that the denial is not due to overpayment but rather that the drug's price was established under the Medicare Drug Price Negotiation Program.
What to Do
- Do not initiate a refund request for the drug in question.
- Confirm that the drug billed falls under the Medicare Drug Price Negotiation Program.
What to Check
- Review the claim adjustment reason code accompanying N908 for more context on the adjustment.
- Verify the drug's status under the Medicare Drug Price Negotiation Program in the system.
- Check the pricing details for the drug to ensure compliance with the maximum fair price.