CARC Code

75

🔵 Informational

Direct Medical Education Adjustment

The payment has been adjusted to account for direct medical education costs, typically associated with teaching hospitals that train residents and interns. This is a contractual adjustment that reduces reimbursement based on educational program funding mechanisms.

contractual
Resolution: 99%Easy difficulty1-3 days avg

How to resolve this denial

Accept GME adjustment — applies to Medicare cost report settlements

  1. 1

    Review the remittance advice to confirm the adjustment amount is accurate

  2. 2

    Verify the contractual write-off against your fee schedule

  3. 3

    Post the adjustment to the patient account

  4. 4

    Do not balance bill the patient for this contractual reduction

  5. 5

    Document the adjustment in your billing system

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✓ Pre-action checklist — verify before contacting the payer
  1. Review the full remittance advice (ERA/EOB) for additional RARC codes that explain the denial.

  2. Verify the claim was submitted with correct patient eligibility and benefit information.

  3. Check if this denial applies to a specific line item or the entire claim.

More about CO-75 — stats, related codes, appeal template

99%

Recovery Rate

1-3 days

Avg. Resolution

Easy

Difficulty

Rare

Frequency

Payer-Specific Notes

How major payers handle CARC 75 by specialty.

UnitedHealthcare

Review UHC's online claim status tool for additional detail on this adjustment.

Appeal Letter Template

Generic appeal template for CARC 75 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 75 indicating: "Direct Graduate Medical Education (GME) Adjustment.." 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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