CARC Code
241
Low Income Subsidy Co-payment
This code indicates the patient's co-payment amount has been adjusted because they qualify for Low Income Subsidy (LIS) assistance under Medicare Part D. The patient is responsible for a reduced co-payment amount due to their LIS eligibility.
patient responsibilityHow to resolve this denial
Request retroactive authorization; submit appeal with clinical documentation
- 1
Pull the original authorization request and approval (if any)
- 2
Determine whether a retroactive authorization request is an option with this payer
- 3
Prepare clinical documentation supporting medical necessity for the service
- 4
Submit the retroactive authorization request through the payer portal
- 5
Submit a formal appeal once the authorization is obtained or denied
- 6
Document all communication with the payer in the patient account
▶✓ 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-241 — stats, related codes, appeal template
35%
Recovery Rate
21-45 days
Avg. Resolution
Hard
Difficulty
Common
Frequency
Payer-Specific Notes
How major payers handle CARC 241 by specialty.
Blue Cross Blue Shield
BCBS requires appeal submission within 180 days for most plans.
Common 835 Combinations
CARC 241 most often appears with these Group Code + RARC combinations on 835 remittances.
Appeal Letter Template
Generic appeal template for CARC 241 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 241 indicating: "No authorization obtained for this service.." 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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