CARC Code
P25
Medical Provider Network Adjustment
The payment was reduced because the services were subject to Medical Provider Network (MPN) rules under a workers' compensation or property and casualty insurance policy. The provider should have followed specific network guidelines that affect reimbursement rates.
contractualHow 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-P25 — stats, related codes, appeal template
0%
Recovery Rate
7-14 days
Avg. Resolution
Medium
Difficulty
Rare
Frequency
Payer-Specific Notes
How major payers handle CARC P25 by specialty.
No payer-specific notes available for this code yet.
Appeal Letter Template
Generic appeal template for CARC P25 denials.
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