CARC 256: Service not payable per managed care contract
Under the managed care contract between your provider and insurer, this specific service isn't separately payable.
What this means for your claim
Managed care contracts define exactly which services are reimbursed and how. A service excluded or bundled under that contract won't be paid separately — but the provider typically cannot bill you for it either.
What to do next
- 1
Confirm with your insurer that this is a provider-contract issue, not a patient-responsibility charge.
- 2
If the provider bills you for a charge denied under their managed care contract, dispute it — contractually adjusted amounts usually cannot be passed to you.
- 3
Request the specific contract provision if you need to escalate the dispute.
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