CARC Code
170
Service Denied - Provider Type Mismatch
The insurance company will not pay for this service because the type of provider who performed or billed it is not allowed to provide that particular service under the patient's plan. This is a denial based on provider qualifications or credentials, not the service itself.
codingHow to resolve this denial
▶✓ Pre-action checklist — verify before contacting the payer
Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.
Verify the claim was submitted with correct patient eligibility and benefit information.
Check if this denial applies to a specific line item or the entire claim.
▶More about CO-170 — stats, related codes, appeal template
35%
Recovery Rate
21-45 days
Avg. Resolution
Hard
Difficulty
Occasional
Frequency
Payer-Specific Notes
How major payers handle CARC 170 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Common 835 Combinations
CARC 170 most often appears with these Group Code + RARC combinations on 835 remittances.
Appeal Letter Template
Generic appeal template for CARC 170 denials.
We are submitting a formal appeal for claim [CLAIM_NUMBER] for patient [PATIENT_NAME], date of service [DOS]. This claim was denied/adjusted with CARC 170 indicating: "Payment denied when performed/billed by this type of provider.." We have reviewed the claim and are providing the attached documentation to support reconsideration. [SUPPORTING_DOCUMENTATION]. Please reconsider payment per the terms of our contract.
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